Over the past 15 years, there has been a significant increase in the total number of operative cases reported to the VSB by both QE and RE applicants. Contrary to popular belief, the volume of major open vascular surgery reported by recent vascular surgery residents has remained relatively stable since 1994. Over the same time period, endovascular procedures have been rapidly incorporated into clinical practice by the majority of vascular surgeons applying for recertification by the VSB. Current vascular surgery residents receive a rich operative experience in both open and endovascular procedures that is reflective of contemporary practice.

A classic case of central giant cell lesion (CGCL) is presented with emphasis on clinical, radiologic, and histologic features. The differential is discussed including peripheral giant cell granuloma, brown tumor of hyperparathyroidism, and giant cell tumor of bone. The molecular pathway of osteoclastogenesis is selectively reviewed and applied to suggest possible etiologies of the giant cell lesions. CGCL syndromes and treatment are also discussed.

FFBP performed with FPV has excellent 1-, 3, and 5-year patency rates. FPV has sustained patency for FFBP in patients with poor runoff.

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Misalignment of the SMA with the use of unstented unreinforced scallops or fenestrations occurs frequently. Routine stenting of single-wide and large fenestrations, when feasible, may be a safer option for patients undergoing FEVAR.