Qualitative Impact of the Endovascular Era on Vascular Surgeons' Comfort Level and Enjoyment With Open and Endovascular AAA Repairs

Objective: To evaluate the qualitative impact of training in the endovascular era (post-2000) on vascular surgeons' comfort level and enjoyment with abdominal aortic aneurysm (AAA) repairs. Methods: A sample of vascular surgeons (n = 1754) were sent a survey pertaining to their fellowship training and practice of AAA repair. The influence of training-and practice-related variables on qualitative outcomes was assessed. Results: A total of 382 (22%) surgeons completed the survey. Surgeons who performed more endovascular aneurysm repairs (EVARs) than open AAA repairs were more likely to enjoy EVAR (P < .001). Those completing fellowship after 2000 reported a higher level of procedure-related comfort with EVAR (P = .001) compared to those completing fellowship before 2000. Conversely, surgeons completing fellowship before 2000 reported a higher level of procedure-related comfort with open AAA repair (P = .001). Conclusion: The advent of EVAR has changed fellowship training of AAA repair and has translated into changes in both practice patterns and comfort level.