Endovascular interventions training and credentialing for vascular surgeons

Abstract

This article reviews issues concerning the training and credentialing of vascular surgeons in the use of endovascular techniques in the peripheral vascular system. These guidelines update a prior document that was published in 1993. They have been rewritten to accommodate the rapid evolution that has occurred in the field and to provide the appropriate requirements that a vascular surgeon should fulfill to be competent in the basic skills needed to safely and effectively perform all presently accepted diagnostic and therapeutic endovascular procedures.

ACC/ACP/SCAI/SVMB/SVS clinical competence statement on vascular medicine and catheter-based peripheral vascular interventions11When citing this document, the American College of Cardiology, American College of Physicians, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and the Society for Vascular Surgery would appreciate the following citation format: Creager MA, Goldstone J, Hirshfeld JW, Kazmers A, Kent KC, Lorell BH, Olin JW, Pauly RR, Rosenfield K,

“…Supervised cases of thrombus management for limb ischemia and venous thrombosis, utilizing percutaneous thrombolysis or thrombectomy, should be included. These requirements are consistent with recommendations and guidelines for endovascular training and hospital credentialling developed and published by the American Association for Vascular Surgery and Society for Vascular Surgery (14).…”

“…Yet there currently exists no common pathway, whether through a formal Accreditation Council for Graduate Medical Education (ACGME) certification process or otherwise, defining how physicians from these or certain other subspecialty training backgrounds should acquire the training and skills necessary to achieve competence in performance of catheter-based peripheral vascular interventions. Moreover, although various guidelines documents have been published in an attempt to set minimum requirements for training (13)(14)(15)(16)(17), a compelling need exists for the minimum requirements to conform to a uniform standard. Standards must take into account the current knowledge regarding the relative complexity of intervention in various vascular beds, as well as the constellation of pre-existing skills, knowledge, and training of physicians from different subspecialties.…”

Society of Interventional Radiology

“…The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) is working with two other accrediting organizations, the National Committee for Quality Assurance and URAC (former- (122,123). Standards of performance and training specifically for peripheral vascular intervention have also been written by the AHA (124), the Society of Cardiac Angiography and Intervention (125), the Society of Interventional Radiology (126,127) and the Society for Vascular Surgery (128). All training and performance standards above require substantial diagnostic angiographic experience prior to interventional practice in all vascular beds, typically 100 angiograms (119 -128).…”

ACC/ACP/SCAI/SVMB/SVS Clinical Competence statement

“…These requirements are consistent with recommendations and guidelines for endovascular training and hospital credentialling developed and published by the American Association for Vascular Surgery and Society for Vascular Surgery. 14 …”