Can vascular surgery perform embolizations for trauma or are these cases reserved for ir

[Benjerm]

Can vascular surgery perform embolizations for trauma or are these cases only performed by ir?

Ex: solid organ, pelvis

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[LucidSplash]

They can as far as training. Actual practice patterns are institution dependent.

 

[kemper6036]

usually its IR at least in the places i've been. most of the time vascular seems to have enough on their plate without being called to squirt a pelvis or do a spleen.

 

[Trauma Surgeon]

Actually, in US, more and more trauma surgeons do also a vascular fellowship. Shock and trauma have at least 2 on their service… But Lucid Spalsh is corret, in US it is institution dependent, but from my talks to several trauma surgeons practicing in "high volume US centers", you will see more vascular trained trauma surgeons in the future.

 

[kemper6036]

I'm very skeptical that (outside of a niche center like Shock Trauma) trauma surgeons would have the volume and practice environment to allow them to keep up adequate endo skills for something like this

thats a lot of extra training for something you probably won't be doing on a regular basis even in a busy center. sounds painful

 

[TypeADissection]

usually its IR at least in the places i've been. most of the time vascular seems to have enough on their plate without being called to squirt a pelvis or do a spleen.

Agreed. If you're at a type of center that will be doing pelvic anglos and embos for traumas, then the referral pattern will also mean that you're probably also going to be fairly busy with cold legs, dissections and ruptures that need to be dealt with as well. It's not an issue of can a vascular surgeon do those things, but more of do they want to extend themselves that much. The sheaths, catheters and wires are all the same. But life can go from zero to mega crap sandwich if you're trying to fix a cold leg while a bleeding pelvis or cracked spleen keeps rolling through the trauma bay.

 

[ACSurgeon]

Actually, in US, more and more trauma surgeons do also a vascular fellowship. Shock and trauma have at least 2 on their service… But Lucid Spalsh is corret, in US it is institution dependent, but from my talks to several trauma surgeons practicing in "high volume US centers", you will see more vascular trained trauma surgeons in the future.

Actually, this is very uncommon in the US. You won't see it happen more in the future either.

 

[Trauma Surgeon]

Actually, this is very uncommon in the US. You won't see it happen more in the future either.

I must disagree! With all the buzz of REBOA and hybrid trauma ORs for taking care of trauma patients, there are two ways to go: additional training in surgical residency for endovascular experience or a fellowship in vascular surgery.
I don't believe that the first option is very feasible since the learning-curve can't be met during a few rotations during residency, and I guess no one is opting for longer residencies, or?
Here is the first meeting discussing the future
http://www.jevtm.com/evtm-symposium/
I'm not totally sold on it (although I'm faculty for the meeting), but I have to admit that this management of trauma patients is growing and we as trauma surgeons have to be prepared to take additional training or have at least a couple of vascular trained surgeons on our services.

 

[doc05]

I must disagree! With all the buzz of REBOA and hybrid trauma ORs for taking care of trauma patients, there are two ways to go: additional training in surgical residency for endovascular experience or a fellowship in vascular surgery.
I don't believe that the first option is very feasible since the learning-curve can't be met during a few rotations during residency, and I guess no one is opting for longer residencies, or?
Here is the first meeting discussing the future
http://www.jevtm.com/evtm-symposium/
I'm not totally sold on it (although I'm faculty for the meeting), but I have to admit that this management of trauma patients is growing and we as trauma surgeons have to be prepared to take additional training or have at least a couple of vascular trained surgeons on our services.

i guess things are different in europe, but this is not gonna happen in the US. too much opportunity cost in adding on additional years of training for zero economic benefit and marginal to no clinical advantage in real world practice.