The obstetric experience among vascular surgery trainees.

Background: Vascular surgery training poses unique risks to pregnancy, including long hours, physically demanding work, and radiation exposure. Our objectives were to (1) understand pregnancy and parenthood experiences among vascular surgery trainees, (2) assess the rate of obstetric complications among vascular trainees, and (3) evaluate factors associated with trainee-parent wellness.

Methods: A survey was administered after the 2021 Vascular Surgery In-Training Examination.

Associations Between Program Doximity Reputation Rank and Well-Being in General Surgery Residents.

Introduction: Burnout and mistreatment are prevalent among surgical residents with considerable program-level variation. Applicants consider "program reputation," among other factors, when ranking programs. Although highly subjective, the only available measure of program reputation is from a physician survey by Doximity.

Reported pain at work is a risk factor for vascular surgery trainee burnout.

Background: Work-related pain is a known risk factor for vascular surgeon burnout. It risks early attrition from our workforce and is a recognized threat to the specialty. Our study aimed to understand whether work-related pain similarly contributed to vascular surgery trainee well-being.

Perception of shared learning environment differs between vascular surgery and general surgery residents.

Background: An enriching learning environment is integral to resident wellness and education. Integrated vascular (VS) and general surgery (GS) residents share 18 months of core GS rotations during the postgraduate years 1-3 (PGY1-3); differences in their experiences may help identify practical levers for change.

Methods: We used a convergent mixed-methods design.

Defining sources and ramifications of mistreatment among female vascular surgery trainees.

Objective: Mistreatment among vascular surgery trainees is a known risk factor for physician burnout. This study aims to characterize forms of and identify sources of mistreatment.

Methods: This is a cross-sectional study of United States vascular surgery trainees who voluntarily participated in an anonymous survey administered after the 2021 Vascular Surgery In-Training Examination.

Thoracic Endovascular Aortic Repair with Supra-Aortic Trunk Revascularization is Associated with Increased Risk of Periprocedural Ischemic Stroke.

Background: Ischemic stroke is a devastating complication of thoracic endovascular aortic repair (TEVAR). This risk may be higher in more proximal aneurysms that require arch manipulation. The purpose of this study is to (1) describe 30-day stroke and death rates in patients undergoing TEVAR, (2) compare stroke rates in patients undergoing TEVAR for arch versus descending aneurysm pathology, and (3) identify predictive factors associated with stroke after TEVAR.

Comprehensive Evaluation of Common Open and Endovascular Procedures and Their Relationship with Postdischarge Complications.

Background: Percutaneous endovascular treatment for arterial vascular diseases has revolutionized vascular care. While these procedures offer improved morbidity, mortality, and length of stay (LOS), their effect on postdischarge complications is unknown. The objectives of the study were to evaluate trends in LOS and postdischarge complications over time and to assess factors associated with postdischarge complications.

Characterizing endovascular aortic intervention outcomes for nonruptured aortic aneurysms by physician specialty.

Background: Evaluate patient outcomes after endovascular aortic interventions performed for nonruptured aortic aneurysms by physician specialties.

Methods: Endovascular aortic repair (EVAR), fenestrated or branched repair (F-BEVAR), and thoracic endovascular aortic repair (TEVAR) procedures were obtained from the Illinois Hospital Association Comparative Health Care and Hospital Data Reporting Services database from 2016 to 2019. Logistic and Poisson regression were used to determine outcomes by patient, physician, and hospital characteristics.

Management of acute aortic syndromes from initial presentation to definitive treatment.

Background: Acute aortic syndromes comprise a spectrum of diseases including aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcers. Early diagnosis, rapid intervention, and multidisciplinary team care are vital to efficiently manage time-sensitive aortic emergencies, mobilize appropriate resources, and optimize clinical outcomes.

Objective: This comprehensive review outlines the multidisciplinary team approach from initial presentation to definitive interventional treatment and post-operative care.

Adjunctive branch interventions during thoracic endovascular aortic repair for acute complicated type B dissection are not associated with inferior outcomes.

Objective: Thoracic endovascular aortic repair (TEVAR) has been shown to effectively treat malperfusion associated with acute type B thoracic aortic dissection (TBAD). A subset of patients might still require adjunctive peripheral or visceral artery branch interventions during TEVAR to remedy persistent end organ malperfusion. Our objectives were to determine the incidence of these adjunctive interventions and to compare the outcomes between patients who had and had not undergone such interventions.

Entrustable Professional Activity-Based Summative Performance Assessment in the Surgery Clerkship.

Objective: The objectives of this study were to 1) assess the performance Entrustable Professional Activities (EPAs) when integrated into the summative assessment of third-year medical students on the surgery clerkship and 2) to compare EPAs to traditional clinical performance assessment tools.

Design: EPA assessments were collected prospectively from a minimum of 4 evaluators at the completion of each surgical clerkship rotation from November 2019 to June 2019. Overall EPA-based clinical performance scores were calculated as the sum of the mean EPA score from each evaluator.

Identifying a Safe Carotid Stump Pressure Threshold for Selective Shunting During Carotid Endarterectomy.

Background: There is no current consensus on the best criteria for selective shunting during carotid endarterectomy (CEA). The choice of continuous neurologic assessment during awake CEA, intraoperative electroencephalogram, or carotid stump pressure monitoring as the basis for shunt placement is primarily dependent on surgeon preference. Our goal is to define a safe stump pressure threshold as a guide for selective shunting.

Thoracic endovascular aortic repair with true-false-true lumen deployment.

Endovascular treatment of aortic dissection may be complicated by challenges to navigating the true lumen. In this report, we describe treatment of a type B dissection after open type A repair with aneurysmal degeneration, a short-segment occluded true lumen, and a distal re-entry tear near the celiac artery origin. Endovascular septal fenestration and subsequent thoracic endovascular aortic repair were used to bypass the short-segment midthoracic aortic occlusion, successfully excluding the thoracic aortic aneurysm.