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1.
Georgian Med News ; (294): 7-10, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687940

RESUMO

Today, the issues of surgical tactics remain unresolved, namely, the choice of volume and area of ​​primary reconstruction with occlusion-stenotic lesions of extracranial arteries and aorto-iliac-femoral segment in conditions of high risk of reperfusion-reoxygenative syndrome. The aim of the study - To improve the results of surgical treatment of combined occlusion-stenotic lesions of extracranial arteries and the aorto-iliac-femoral segment in conditions of high risk of development of reperfusion-reoxygenative complications. The study included 58 patients with combined atherosclerotic lesions of extracranial arteries and aorto-iliac-femoral zone. To diagnose the nature of the lesion of the arterial bed and the features of hemodynamic disorders, ultrasound dopplerography, duplex scanning, X-ray contrast digital angiography were used. The proposed set of measures to prevent the development of reperfusion-reoxygenative complications was introduced to the system of preoperative preparation. The decision of the order of restorative operations on the brachiocephalic arteries and the aorto-iliac-femoral segment was based on the analysis of the localization of the occlusive process in both arterial basins, their hemodynamic characteristics, the degree of ischemia and the tolerance of the brain to ischemia. Due to the spread occlusion-stenotic lesion of extracranial arteries in combination with the stenotic process of the contralateral ICA in the stage of relative compensation of cerebral bloodflow in 7 patients, primarily the surgical intervention on the vessels of the neck was performed. Four to six days after the first surgical intervention, the revascularization of aorta/iliac-femoral segment was performed. In 51 patients, one-time surgical intervention was performed on extracranial arteries and aorto-iliac-femoral basin. Analyzing the results of revascularization operations, it can be argued that a differentiated approach to choosing the tactics of surgical treatment of multifocal atherosclerotic lesions of arterial basins should be used. The revascularization of both arterial basins should be carried out in stages: a reconstructive operation on the extracranial arteries is performed initially, and 4 to 6 days after the first surgical intervention, the aorta/iliac-femoral arterial zone revascularization or revascularization of both arterial basins simultaneously.


Assuntos
Aorta Abdominal/diagnóstico por imagem , Arteriopatias Oclusivas/cirurgia , Artérias/diagnóstico por imagem , Ultrassonografia Doppler Dupla/métodos , Procedimentos Cirúrgicos Vasculares/métodos , Idoso , Angiografia Digital , Aorta Abdominal/patologia , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Artéria Ilíaca/diagnóstico por imagem , Artéria Ilíaca/cirurgia , Masculino , Pessoa de Meia-Idade , Traumatismo por Reperfusão/prevenção & controle
3.
Kyobu Geka ; 72(10): 772-776, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582694

RESUMO

The important point in vascular anastomosis is anastomosis with a secure suture and prevention of thrombosis. Uncertainty in sutures can cause bleeding from the anastomotic site and post operative pseudoaneurysm formation. In addition, the failure of the antithrombotic function causes early occlusion of the anastomotic site due to thrombus formation, causing intimal thickening and causing stenosis of the anastomotic site. Vascular anastomosis must be performed with attention to the property and site of the blood vessel, the method of graft formation, and the procedure of suturing. Training is required for fast and accurate sutures, and it is also important to conduct off the job training to efficiently improve your proficiency.


Assuntos
Artérias , Suturas , Anastomose Cirúrgica , Constrição Patológica , Humanos , Técnicas de Sutura , Procedimentos Cirúrgicos Vasculares
4.
Kyobu Geka ; 72(10): 777-780, 2019 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-31582695

RESUMO

It is well known that proximal part of a sequential bypass grafting often demonstrates better patency than distal part does due to more favorable hemodynamics of side-to-side anastomosis. Therefore, we adopt side-to-side anastomosis( parallel fashion) even for most distal part of bypass grafting. In addition to superiority in hemodynamics, side-to-side anastomosis (parallel fashion) provides a couple of advantages such as ① easiness in creating a very long opening of the anastomosis, ② compatibility in size (diameter) mismatch between graft conduit and coronary artery, and ③ excellent hemostasis from the suture line. This article describes technical details and tips of side-to-side anastomosis in both parallel fashion and diamond( cross direction) fashion.


Assuntos
Ponte de Artéria Coronária , Vasos Coronários , Anastomose Cirúrgica , Hemodinâmica , Grau de Desobstrução Vascular , Procedimentos Cirúrgicos Vasculares
5.
Zhonghua Yi Xue Za Zhi ; 99(37): 2912-2915, 2019 Oct 08.
Artigo em Chinês | MEDLINE | ID: mdl-31607020

RESUMO

Objective: To study the effect and safety of vertebral artery stent implantation via femoral artery and radial artery. Methods: Twenty-four patients with vertebral artery stent implantation from December, 2017 to August, 2018 in Beijing Anzhen Hospital were randomized into 2 groups, one was research group with 12 patients, the other was control group with 12 patients. The research group underwent vertebral artery stent implantation via radial artery, the control group underwent vertebral artery stent implantation via femoral artery. The follow-up results of the two groups were analyzed. Results: The success rate of the first puncture in the research group was 100%, significantly higher than 83.33% of the control group, there was no statistical difference (χ(2)=2.528, P>0.05).The implantation time of sheath tube in the research group was (3.2±0.3) min, significantly longer than that in the control group (2.4±0.2) min, the difference was statistically significant (t=7.713, P<0.001). The time from sheath insertion to balloon dilation and bed rest time after operation in the research group were 17.3 (16.2-17.9) min, significantly less than the control group (27.1(26.1-28.3) min), the difference was statistically significant (Z=-4.157, P<0.001). The time of bed rest in the research group was 2.1 (2.0-2.2)h, significantly less than the control group (27.1(25.3- 28.9)h), the difference was statistically significant(Z=-4.167,P<0.001). No cerebrovascular events occurred during the follow-up period. One patient in the control group developed complications of vagal reflex, no patient in the research group developed complications. Conclusions: Vertebral artery stent implantation via radial artery can significantly improve the success rate and safety of the operation. Radial artery approach is a better choice for vertebral artery stent implantation.


Assuntos
Artéria Femoral , Artéria Radial , Stents , Humanos , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares , Artéria Vertebral
6.
Khirurgiia (Mosk) ; (10): 75-81, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31626243

RESUMO

Postoperative complications in vascular surgery may be partly provoked by suture material. Analysis of the mechanisms of these complications may be useful for their prevention. Mechanisms of suture-induced thrombosis and neointimal hyperplasia, possible strategies for prevention of postoperative complications including those allowing drug deliveries directly to the vascular anastomosis area are discussed in the article. According to the literature data, heparin is the most optimal drug for modifying suture material and prevention of thrombosis and neointimal hyperplasia. Heparin delivery to the vascular anastomosis site will reduce the risk of thrombosis by inhibiting the activity of thrombin. Complex of heparin and antithrombin III increases inhibitory effect of antithrombin against thrombin. In addition, heparin is able to reduce proliferation of vascular smooth muscle cells through inhibition of the synthesis of extracellular matrix proteases involved in migration and proliferation of cells. Thus, heparin delivery to the vascular injury site may be used to prevent thrombosis and myoproliferative response. Moreover, this strategy prevents complications associated with systemic administration of anticoagulants.


Assuntos
Suturas/efeitos adversos , Trombose/prevenção & controle , Doenças Vasculares/prevenção & controle , Procedimentos Cirúrgicos Vasculares/efeitos adversos , Anticoagulantes/administração & dosagem , Heparina/administração & dosagem , Humanos , Hiperplasia/etiologia , Hiperplasia/patologia , Hiperplasia/prevenção & controle , Neointima/patologia , Trombose/etiologia , Doenças Vasculares/etiologia
7.
Medicine (Baltimore) ; 98(43): e17575, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651860

RESUMO

RATIONALE: Chylothorax remains a poorly understood phenomenon, and no optimal treatment or guidelines have been established. This is the first report of treating congenital chylothorax and lymphedema in a low-birth-weight infant by lymphovenous anastomosis (LVA). PATIENT CONCERNS: We report a case of successful LVA for persistent congenital chylothorax and lymphedema resistant to other conservative therapies. DIAGNOSIS: The diagnosis of chylothorax was confirmed by the predominance of lymphocytes in the pleural fluid draining from the chest tube. In addition, the infant developed oliguria and generalized lymphedema. INTERVENTIONS: LVA under local anesthesia combined with light sedation was performed at his medial thighs and left upper arm. OUTCOMES: Although his subcutaneous edema markedly improved, the decrease in chest tube drainage was gradual. No additional treatment was required. LESSONS: LVA is of considerable value as a surgical treatment option in the setting of persistent congenital chylothorax and lymphedema, because LVA is a less invasive procedure.


Assuntos
Quilotórax/congênito , Vasos Linfáticos/cirurgia , Procedimentos Cirúrgicos Vasculares/métodos , Anastomose Cirúrgica/métodos , Quilotórax/cirurgia , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Cavidade Pleural/cirurgia
8.
Int Heart J ; 60(5): 1131-1136, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484859

RESUMO

Reinforcing the dissected and fragile aortic root is critical in acute type A aortic dissection (ATAAD) surgery. This study introduces our new aortic root reinforcement technique and reports our early operative results and midterm follow-up results.A retrospective analysis study was performed on 235 patients (aged 53.2 ±15.5 years) who were admitted to our hospital for ATAAD surgery and underwent the procedure with our new technique between October 2011 and June 2016. Two vascular graft rings were placed inside and outside aortic root, followed by a running horizontal mattress suture, placed just above the coronary artery ostiums and aortic valve commissures, with another horizontal suture at distal end of the aortic root stump, to reinforce the inner vascular graft, aortic wall, and outside vascular graft. Then additional 3-5 vertical mattress sutures were placed for further reinforcement within the reconstructed aortic root. Computed tomography angiography was performed at discharge and annually during follow-up.The patients' 30-day mortality was 5.1% (12/235). There was no uncontrollable intraoperative bleeding from the aortic root, and re-exploration for bleeding occurred in 0.79% (2/235). The survival rate was 90.2% during follow-up of 4.2 ± 2.1 years. There were no requests for aortic root reoperations during follow-up. All patients were free from aortic root disruptions, proximal anastomosis complications, and re-dissections of the reconstructed aortic root.Our new aortic root reinforcement technique provides a safe and effective technique for aortic root in ATAAD surgery, by reinforcing friable aortic root tissues and minimizing aortic root complications.


Assuntos
Aneurisma Dissecante/mortalidade , Aneurisma Dissecante/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Mortalidade Hospitalar/tendências , Procedimentos Cirúrgicos Vasculares/métodos , Adulto , Idoso , Aneurisma Dissecante/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/mortalidade , Ponte Cardiopulmonar/métodos , China , Estudos de Coortes , Terapia Combinada , Angiografia por Tomografia Computadorizada/métodos , Feminino , Hospitais Universitários , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Taxa de Sobrevida , Técnicas de Sutura , Resistência à Tração , Resultado do Tratamento
9.
Br J Anaesth ; 123(5): 565-569, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31547970

RESUMO

This case series presents 10 patients undergoing vascular surgery with asymptomatic elevated high-sensitivity troponin T concentrations, measured at outpatient clinic before surgery. Patients were included in the RAVE (Rotterdam Antiplatelet therapy in Vascular patiEnts) pilot study. All included patients underwent coronary angiography before surgery to identify significant obstructive coronary artery disease. We identified five out of 10 patients with high-grade stenosis and high-risk angiographic features of left main and/or proximal left anterior descending coronary artery disease. The study was terminated prematurely before any subject reached the study endpoint of 1 yr follow-up. This case series provides more insight into the meaning of preoperative troponin elevation and coronary angiographic features in vascular surgery patients. TRIAL REGISTRY NUMBER: NL5803.


Assuntos
Angiografia Coronária/métodos , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Cuidados Pré-Operatórios/métodos , Troponina T/sangue , Procedimentos Cirúrgicos Vasculares , Idoso , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/cirurgia , Método Duplo-Cego , Feminino , Humanos , Masculino , Projetos Piloto , Fatores de Risco
12.
Angiol Sosud Khir ; 25(3): 122-127, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31503256

RESUMO

Occlusion of the superficial femoral artery is a frequently encountered pathology in peripheral vascular disease. In patients with chronic lower limb ischaemia in a lesion of crural arteries the results of femoropopliteal bypass grafting are unsatisfactory, therefore, the deep femoral artery becomes the decisive collateral pathway for perfusion of the lower extremity. PATIENTS AND METHODS: The study included a total of 166 patients presenting with TASC II B, C and D type lesions of the femoropopliteal segment after profundoplasty, who were subdivided into 3 groups depending on the stage of chronic lower limb ischaemia: Group 1 - 95 patients with stage II B, Group 2 - 56 patients with stage III, and Group 3 - 15 patients with stage IV. RESULTS: Five years after profundoplasty in Group 1 amputation was avoided in 90 patients (94.7%) in Group 2 - in 47 patients (83.9%), where p=0.028. During 14 months in Group 3 due to unsatisfactory distal bed 15 patients (100%) were subjected to amputation of the operated lower limb at various levels. The binary logistic regression analysis of the diameter of the deep femoral artery (p=0.045, OR=0.139) and the state of the distal arterial bed (p=0.02, OR=9.341) demonstrated that the diameter of the artery directly influenced the outcome of profundoplasty within up to 5 years. CONCLUSION: Profundoplasty is an effective operation from the point of view of clinical and haemodynamic outcomes for patients presenting with occlusion of the superficial femoral artery and stenosis of the deep femoral artery with stage IIB and III chronic lower limb ischaemia. The diameter of the deep femoral artery and the condition of the arterial bed are the factors influencing the results of profundoplasty within up to 5 years.


Assuntos
Isquemia , Doenças Vasculares Periféricas , Procedimentos Cirúrgicos Vasculares , Artéria Femoral , Humanos , Isquemia/cirurgia , Extremidade Inferior/irrigação sanguínea , Doenças Vasculares Periféricas/cirurgia , Artéria Poplítea , Resultado do Tratamento , Grau de Desobstrução Vascular
13.
Angiol Sosud Khir ; 25(3): 129-134, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31503257

RESUMO

Surgical management of patients with tumour invasion of major veins by means of their resection and simultaneous reconstruction is an actively developing trend in modern surgery. The article describes a clinical case report concerning treatment of a patient presenting with disseminated neuroendocrine cancer of the pancreatic head and subjected to pancreatoduodenal resection with a complicated variant of mesenteric-portal reconstruction and the use of a graft made of porous polytetrafluoroethylene, followed by relapse-free survival of more than 5 years. In our case report, despite complexity of forming a proximal anastomosis, the findings of multislice computed tomography with 3D-reconstruction 4 months after the operation demonstrated uneven circular thickening of the graft's wall by 1-2 mm, which might be interpreted as neointimal hyperplasia. The maximum thickness amounted to 2 mm in the area of the distal anastomosis. Thus, the internal diameter of the graft varied from 8 to 9 mm. The minimum thickness was observed in the middle portion of the graft, amounting to 1 mm. The findings of computed tomography at 60 postoperative months demonstrated no evidence of the disease's progression, the portal system of the liver contrasted evenly, the mesenteric-portal graft fully patent, showing parietally a thin uneven low-density strip 1-2 mm thick (with the maximum thickness observed in the area of anastomoses and the minimum thickness in the centre of the graft). Thus, the obtained findings are suggestive of high efficacy, safety, and feasibility of using polytetrafluoroethylene grafts for reconstruction of major veins in clinical practice. More randomized studies are necessary to confirm our conclusions.


Assuntos
Invasividade Neoplásica , Politetrafluoretileno , Próteses e Implantes , Procedimentos Cirúrgicos Vasculares , Humanos , Hiperplasia , Sistema Porta , Veias/patologia , Veias/cirurgia
14.
Angiol Sosud Khir ; 25(3): 157-162, 2019.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-31503260

RESUMO

The patient was 62-year-old male who successfully underwent an anatomic repair of aortic coarctation at the age of 15 and an extra-anatomic ascending aorta- to-descending aorta bypass (graft size 20 mm) and an extra-anatomic ascending aorta to the left subclavian artery bypass (graft size 10 mm) at the age of 49. As he grew older he started presenting clinical symptoms of aortic stenosis. The echocardiogram showed a bicuspid aortic valve with severe stenosis and a mean gradient of 65 mm Hg. Despite the high surgical risk, we decided to perform an open valve replacement with installing the CPB prior to re-sternotomy with a simultaneous cannulation of the axillary and femoral arteries by reason of interrupted descending aorta. The postoperative course was uneventful.


Assuntos
Coartação Aórtica , Valva Aórtica , Implante de Prótese de Valva Cardíaca , Procedimentos Cirúrgicos Vasculares , Aorta , Aorta Torácica , Coartação Aórtica/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
15.
Angiol Sosud Khir ; 25(3): 167-176, 2019.
Artigo em Inglês, Russo | MEDLINE | ID: mdl-31503262

RESUMO

The persistent sciatic artery is situated superficially in the gluteal region wherein it can be traumatized in normal daily activities: during a prolonged sitting position or while attempting to sit down. This leads to an early atherosclerotic lesion of the sciatic artery, to the development of aneurysmatic dilatation, and damage to the arterial wall. The present article describes a 72-year-old female patient presenting with a persistent sciatic artery of the left leg and a PSA aneurysm which consequently resulted in critical ischaemia of her left lower limb. This abnormality was detected during an examination and the woman was subjected to the operation of internal iliac-posterior tibial bypass grafting using an autologous vein with ligation of the sciatic artery. The bypass graft has been functioning for 5 months, with no events of critical ischaemia.


Assuntos
Aneurisma , Perna (Membro) , Idoso , Aneurisma/diagnóstico , Aneurisma/cirurgia , Artérias/patologia , Artérias/cirurgia , Feminino , Humanos , Isquemia , Perna (Membro)/irrigação sanguínea , Ligadura , Procedimentos Cirúrgicos Vasculares
16.
Zhongguo Zhen Jiu ; 39(9): 983-6, 2019 Sep 12.
Artigo em Chinês | MEDLINE | ID: mdl-31544388

RESUMO

Professor LIN Guo-hua is the representative inheritor of Lingnan fire needling therapy. He proposed that the clinical application of Lingnan fire needling is mainly based on pattern differentiation according to eight priciples, as well as in coordination with the theories of meridians and zang-fu organs. He believes that dry eye syndrome can be treated from the aspects of deficiency of liver and kidney, heart yin deficiency, and qi and yin deficiency. Through deeply digging the connotation of ancient classics, and combined his clinical practice using Lingnan fire needling, professor LIN created a unique therapy that select "Neichengqi"as the main acupoint combined with Xialeidian, Dagukong (EX-UE 5), Xiaogukong (EX-UE 6) and Shaoze (SI 1) in the treatment of dry eye syndrome. In this paper, from the etiology and pathogenesis of dry eye syndrome and therapeutic characteristics of Lingnan fire needling, the thoughts of syndrome differentiation and characteristics of acupoints selection of professor LIN were analyzed by a typical case, and it is expect to enrich the clinical treatment plan for dry eye syndrome.


Assuntos
Terapia por Acupuntura , Síndromes do Olho Seco , Meridianos , Pontos de Acupuntura , Síndromes do Olho Seco/terapia , Humanos , Procedimentos Cirúrgicos Vasculares
17.
Ann R Coll Surg Engl ; 101(8): 584-588, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31537105

RESUMO

INTRODUCTION: The National Institute for Health and Care Excellence published a draft consultation update on abdominal aortic aneurysm, which was expected to be published on 7 November 2018. This article analyses the readiness of NHS hospitals and their workforce to embrace the proposed guidelines. METHODS: The trust and individual surgeon-level anonymised data in the public domain for elective, rupture and complex abdominal aortic aneurysm cases were collected and analysed for all the acute care trusts providing these services from the Vascular Society of Great Briton and Ireland's prospective National Vascular Registry database. RESULTS: Of the 95 acute care trusts providing the service for the year 2017, the annual volume of infrarenal abdominal aortic aneurysm (both endovascular and open repairs) ranged between 0 and 137. Of these, 64 (67.36%) trusts had an annual volume of fewer than 60 cases. A total of 366 (approximately 75% of 490) vascular surgeons have performed 10 or fewer open abdominal aortic aneurysm repairs in three years (2014-2016) with a mean operating volume of 1.452 procedures per surgeon per three years (n = 254, median 0, interquartile range, IQR, 0-3, 0.484 procedures per surgeon per year) and about 51% of the vascular surgeons have only performed five or fewer procedures in those three years with a mean operating volume of 3.455 per surgeon per three years (n = 367, median 3, IQR 0-3, 1.151 per surgeon per year). CONCLUSION: The observations show that most UK acute hospitals lack the optimum case volume necessary to embrace the proposed change in the guideline.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Guias de Prática Clínica como Assunto , Procedimentos Cirúrgicos Vasculares/normas , Aneurisma da Aorta Abdominal/epidemiologia , Ruptura Aórtica/epidemiologia , Ruptura Aórtica/cirurgia , Bases de Dados Factuais , Procedimentos Cirúrgicos Eletivos/normas , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Emergências , Medicina Baseada em Evidências/métodos , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Irlanda/epidemiologia , Sistema de Registros , Medicina Estatal/normas , Medicina Estatal/estatística & dados numéricos , Reino Unido/epidemiologia , Procedimentos Cirúrgicos Vasculares/métodos , Procedimentos Cirúrgicos Vasculares/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos
18.
Semin Vasc Surg ; 32(1-2): 14-17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540649

RESUMO

The recognition of vascular surgery as an independent surgical specialty is inevitable, but the pathway to full autonomy remains uncertain. Vascular surgery emerged from general surgery in the mid-1950s with the advent of synthetic grafts and microvascular techniques. By the early 1980s, Accreditation Council for Graduate Medical Education-approved fellowships were established in most large academic medical centers. The American Board of Surgery recognized this additional specialty training by awarding vascular graduates a Certificate of Special Qualifications distinguishing them from general surgeons. The emergence of endovascular surgery radically changed the face of vascular surgery from a general surgery subspecialty to a unique surgical specialty with a growing array of minimally invasive tools. With the establishment of a primary Certificate in Vascular Surgery and the subsequent development of integrated residencies, vascular surgery moved ever closer to recognition as an independent surgical specialty. Despite the remarkable progress that has been observed over the past 50 years, there is a desire in the vascular community for formal recognition of the unique body of knowledge and surgical skills that serve as the foundation of contemporary vascular care.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Autonomia Profissional , Conselhos de Especialidade Profissional , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Competência Clínica , Currículo , Educação de Pós-Graduação em Medicina/história , Educação de Pós-Graduação em Medicina/normas , Educação de Pós-Graduação em Medicina/tendências , Previsões , História do Século XX , História do Século XXI , Humanos , Conselhos de Especialidade Profissional/história , Conselhos de Especialidade Profissional/normas , Conselhos de Especialidade Profissional/tendências , Cirurgiões/história , Cirurgiões/normas , Cirurgiões/tendências , Estados Unidos , Procedimentos Cirúrgicos Vasculares/história , Procedimentos Cirúrgicos Vasculares/normas , Procedimentos Cirúrgicos Vasculares/tendências
19.
Semin Vasc Surg ; 32(1-2): 18-20, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540650

RESUMO

The training of vascular surgeons in Canada has evolved over the past decade. Direct entry into a vascular surgery training program after medical school has been offered since 2012. At some institutions, it is the only option for surgery training. The smaller population of Canada and a single-payer health care system has resulted in unique opportunities and challenges for the training of vascular surgeons and providing opportunities for trainees to transition into clinical practice.


Assuntos
Certificação , Educação de Pós-Graduação em Medicina/métodos , Internato e Residência , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/economia , Canadá , Currículo , Humanos
20.
Semin Vasc Surg ; 32(1-2): 21-22, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31540651

RESUMO

The development of the 0+5 integrated vascular training program allows training to begin after medical school and is a "new" paradigm in specialty surgery training. Whether community and academic surgeons in practice will accept this training program remains an unanswered question. My perspectives as an integrated vascular resident trainee who recently entered clinical practice provide insight on the adequacy of my training and the lessons I have learned as a vascular surgery specialist.


Assuntos
Escolha da Profissão , Certificação , Cirurgiões/educação , Procedimentos Cirúrgicos Vasculares/educação , Fatores Etários , Atitude do Pessoal de Saúde , Competência Clínica , Currículo , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Relações Interpessoais , Descrição de Cargo , Avaliação de Programas e Projetos de Saúde , Cirurgiões/psicologia , Local de Trabalho/psicologia
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