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Vascular as a branch of CT?

Discussion in 'Surgery and Surgical Subspecialties' started by HMSBeagle, May 13, 2008.

  1. HMSBeagle

    HMSBeagle 10+ Year Member

    Dec 27, 2007
    Hi. After reading the posts here it is obvious that my hospital does things a little different. Here we have the cardiac surgeons basically also doing the majority of the vascular surgeries (AAA,carotids, lower extremities bypass, etc..) but they don't do any endovascular stuff. Therefore here the CT guys do cardiac, chest and vascular. Is this how many hospitals work or not?
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  3. Winged Scapula

    Winged Scapula Cougariffic! Staff Member Administrator Physician Faculty Lifetime Donor Classifieds Approved 15+ Year Member

    Apr 9, 2000
    hSDN Member
    Not in my experience (which is colored by having trained in the NE...haven't seen enough out here in Az to get a feel for local practices yet).

    In all the hospitals I've worked in, Vascular surgeons do AAAs (open and endovascular), carotids (some done by Nsgy as well), upper and lower extremitie bypasses, etc.

    CT sticks to the heart, lungs and occasional goose (shared with Surg Onc).
  4. Castro Viejo

    Castro Viejo Papa Clot Buster 10+ Year Member

    Jun 3, 1999
    It certainly depends on where in the country you are and the area's supply of physicians and surgeons. In the Northeast you'll almost never see any peripheral vascular stuff being done by anyone other than a trained Vascular Surgeon.

    The situation you describe sounds a lot like what one of my Chiefs describes is the case in Florida. There's sort of a short supply of surgeons there, nevermind Vascular Surgeons, and so a lot of the peripheral work is done by General and Cardiothoracic guys.

    Also realize that as the caseload for Cardiac goes I into the toilet, these guys need to make a buck or two somehow. So why not do Peripheral Vascular stuff?
  5. Castro Viejo

    Castro Viejo Papa Clot Buster 10+ Year Member

    Jun 3, 1999
    Oops... It posted before I was done.

    Anyway without an independent board in Vascular Surgery any General Surgeon, and by extension, any Cardiothoracic Surgeon, could do peripheral vascular stuff because they were trained to do so at some point.

    But what are they truly offering? Is it really the best option for the patient?

    There are plenty of things that vascular surgeons can do today for peripheral vascular disease without cutting that General and Cardiac guys can't do. I bring up the example, again, of my old Chief who's in PP in Florida. He described a TASC A lesion that he did an aortofemoral bypass on when the lesion is more than adequately treated with a wire in today's modern world.

    But what gave him the right to do that was the nonexistence of an independent Board of Vascular Surgery.

    An aortofemoral bypass can be a fairly morbid operation when compared to putting in a groin sheath for your wire work, no?

    Anyway, you'll see from time to time Cardiac and General people taking on peripheral vascular surgery.
  6. That doesn't happen here either. Only thoracic aortas get handled by CT...AAAs, carotids, peripheral bypasses (e.g. fem-distals), etc. all get handled by Vascular.
  7. njbmd

    njbmd Guest Moderator Emeritus 5+ Year Member

    May 30, 2001
    Gone Walkabout!
    Before vascular surgery split into its own fellowship, it was a branch of CT surgery. Many of the folks who trained in the fellowships that were Cardiovascular Surgery will perform vascular procedures. A couple of the CT surgeons at my old residency location did perform some vascular because they liked the procedures.
  8. ESU_MD

    ESU_MD Old School 10+ Year Member

    Nov 17, 2001
    Big Leagues
    Alot of the true "oldtimers" pride themselves as cardiovascular, CV surgeons.

    These guys were pretty good, but the CT training is different now, One cannot find a true CV fellowship without doing CT and Vascular seperately.

    If any 2 specialties are well suited for crossover it is CT/Vasc, both need expert technical skills, and attention to detail. With all the endo stuff needed to be a rounded vascular surgeon in modern times, it is unlikely that a single combined 2 yr fellowship would train for both,

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