Vascular Surgeon Involvement in Pulmonary Embolism Response Teams: Barriers, Challenges, Concerns and the Imperative for Integration.

Background: The effective management of pulmonary embolism (PE) necessitates coordinated care among physicians from diverse specialties within a time-sensitive framework. Pulmonary Embolism Response Teams (PERTs) have been developed as a strategic approach to optimize and expedite treatment by integrating and coordinating different specialties. The current survey audit aimed to understand the level of interest among vascular surgeons and the logistical considerations surrounding their participation within the PERT.

Methods: A deidentified Research Electronic Data Capture (REDCap) survey was disseminated to vascular surgeons, with collected data submitted to the Vascular Surgery Collaborative (VASC) database.

Results: A total of 139 vascular surgeons with an average of 10.6 years of practice experience responded to the VASC PERT audit. The majority (70.5%) practice in academic settings and only 24.5% currently perform PE interventions in their practice. While nearly half of respondents (52.5%) reported the existence of PERT in their institutions, only a fraction (23.3%) was actively involved in the PERT. Notably, a significant proportion in our cohort (38.1%) expressed dissatisfaction with the representation of vascular surgeons in multidisciplinary teams managing venous thromboembolism (VTE), including deep vein thrombosis (DVT) and PE. Vascular surgery (VS) representation in PERT was only 34.2%, with pulmonology (pulm) (60.3%), interventional radiology (IR) (57.5%), interventional cardiology (IC) (57.5%), and critical care (CC) (50.7%) being the most represented specialties. The primary barriers to VS participation in PERT were competing interests from other specialties and logistical scheduling challenges.

Conclusions: The audit shows a global deficit in the integration of VS expertize within PERT frameworks. Primary barriers include exclusion due to competing interests from other specialties and challenges in the logistical coordination of PERT calls.