title: Impact of endovascular technique in vascular surgery training at a large university hospital in Brazil.
abstract: OBJECTIVE
  The aim of this study was to determine the impact of endovascular surgery versus open vascular technique training in a Brazilian teaching service.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Hospital das Clinicas-Faculty of Medicine-University of Sao Paulo, a tertiary institutional hospital-Brazil.
  
  
  METHODS
  We reviewed 1,040 arterial operations performed during 2 distinct time periods: January 1995 to December 1996, and January 2006 to December 2007. Based on the disease treated, the procedures were classified into the following 5 groups: abdominal aortic aneurysms (AAA), aorto-iliac obstructive disease (AI), obstructive disease of the femoropopliteal-tibial segment (FP), carotid disease (C), and others (O). The operations were also divided into an endovascular surgery (ES) group and an open surgery (OS) group. We compared the number of open and endovascular procedures for each arterial disease group during both periods.
  
  
  RESULTS
  During the 2006-2007 period, 654 patients were treated surgically, whereas over the 1995-1996 period, 386 arterial operations were performed. A significant increase in endovascular procedures (p < 0.001) was found from the 1995-1996 period to the 2006-2007 period (35 vs 351, respectively) in all groups, whereas open surgery showed a slight increase in the number of procedures in the AAA and O groups only. In the 1995-1996 period, OS was the primary surgical method for all groups, but in the 2006-2007 time frame, OS was performed more frequently than ES only in the AAA and O groups. Considering all vascular disease groups, OS was the technique used in 90.9% (351 of 386) of the operations during 1995-1996, whereas in 2006-2007, OS was performed in only 46.3% (303 of 654) of the procedures.
  
  
  CONCLUSIONS
  The increase in the number of ES observed over the past decade has had little impact on OS procedures performed at our medical center, not bringing harm to open surgical training.
authors.affiliation: Division of Vascular and Endovascular Surgery, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Pedro
authors.initials: P
authors.lastname: Puech-Leão
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: Antonio E
authors.initials: AE
authors.lastname: Zerati
authors.forename: Luciano D
authors.initials: LD
authors.lastname: Nascimento
mesh_terms: D000367:Age Factors; D000368:Aged; D001938:Brazil; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate / Q000379:methods; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D057510:Endovascular Procedures / Q000193:education* / Q000379:methods; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000193:education / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D011787:Quality of Health Care; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000175:diagnosis / Q000601:surgery; D014656:Vascular Surgical Procedures / Q000193:education* / Q000379:methods