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Volume and Vision in Vascular Care

Joe Cantlupe, for HealthLeaders Media, October 5, 2011
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Hospitals also are expanding vascular care through catheterization lab procedures and rapid access for patients with abdominal aortic aneurysms, a potentially life-threatening condition resulting from a tear or damage to the inner wall of the aorta.

Processes are being developed within aortic centers to provide immediate and 24/7 assistance to local hospitals and physicians for rapid diagnosis and treatment of aortic emergencies. Patients with acute aortic syndrome represent some of the most serious and lethal problems that may be seen in an ED or physician’s office. Nearly 200,000 people in the United States are diagnosed with abdominal aortic aneurysm annually, and about 10,000 die each year.

The syndrome refers to a spectrum of aortic emergencies including rupturing aneurysms, aortic dissections, and penetrating aortic ulcers. Because these conditions can have a mortality rate of 40% or higher if not diagnosed and treated within 24 hours, rapid assessment and intervention by experienced surgeons is essential. Vascular disease can range from life-threatening conditions such as arterial blockages that cause strokes, to less dangerous but painful conditions, such as varicose veins. Vascular disease primarily affects senior citizens, and the disease is expected to increase as the baby boomer population ages.

Greg Kasper, MD, FACS, chief vascular surgeon for the 445-bed Mercy St. Vincent Medical Center in Toledo, OH, says that vascular surgery will be in continued demand in hospitals. “With the aging population and the incidence of diabetes continuing to rise, as well as a significant population that still smokes, there is a huge need and that is only increasing,” he says.

Before the Mercy St. Vincent Medical Center system built a new heart and vascular center five years ago, “the leaders here were talking about just building a heart center. They were told, ‘You are crazy if you don’t involve vascular in the mix,’ and they did,” Kasper says. “It was a right move.”

Although there is expected to be an increasing demand for vascular surgery, the number of physicians has not yet kept pace. There was an estimated 2.1% shortage of vascular surgeons for patient need in 2010, but that is expected to increase to 6.1% by 2020, and could reach 19% by 2050, according to the Society for Vascular Surgery, which has a membership of 2,400 surgeons. As a result, hospitals are initiating residency programs to improve vascular surgery training. “There’s definitely going to be a need for vascular surgeons with the increasing aging population,” Kasper says.

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