Medical Centers With Vascular Surgery Training Programs Are More Likely To Utilize Autologous Vein And Vein Mapping

Document Type

Conference Proceeding

Publication Date

3-1-2025

Publication Title

Ann Vasc Surg

Keywords

adult, aged, conference abstract, controlled study, female, hospital charge, human, major clinical study, male, multicenter study, multivariate analysis, surgical training, therapy, training, vascular surgery, vascularization

Abstract

Introduction and Objectives: The Society for Vascular Surgery recommends pre-operative vein mapping (PVM) and autologous vein conduits when available for patients undergoing infrainguinal bypass (IIB). This study aims to explore the potential relationship between the presence of a vascular surgery training program (VSTP) at medical centers and the utilization of PVM and autologous vein conduits for IIB. Methods: Patients who underwent IIB between 2016-2022 were identified in a statewide vascular surgery registry of 49 different medical centers. Medical centers were split into those with and without a VSTP. Bayesian mixed effects logistic regression was used to evaluate the association between having a VSTP and the utilization of PVM and autologous vein conduits. Results: A total of 5,951 patients and thirty-seven medical centers were included, of which 24% (9/37) had a VSTP. Hospital rates of PVM utilization varied (range 10%-82%, median 41%), while that of autologous vein utilization ranged between 16%-88% (median 44%). Centers with a VSTP were more likely to utilize PVM (58% vs 39%, p<0.001) and autologous vein (55% vs 43%, p<0.001) compared to those without a VSTP. On multivariate analysis, centers with a VSTP were associated with a two-fold increase in PVM utilization (OR 2.23; 95% CI 1.03-4.77) and were more likely to utilize autologous vein conduits (OR 1.83, 95% CI 1.61-2.08, p<0.001). A strong linear relationship between PVM and autologous vein utilization was observed (R-squared=0.96) (Figure). Conclusions: Medical centers with specialized vascular surgery training programs are more likely to utilize PVM and autologous vein conduits in patients undergoing IIB. This adherence to best medical practices may be attributed to a pervasive culture of scientific inquiry nurtured within the environment of a teaching program. [Formula presented]

Volume

112

First Page

409

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