Department of Internal Medicine and Angiology, HELIOS-Hospital Salzgitter, Germany.
Department of Cardiology I, University Hospital Münster, Germany.
Vasa. 2023 Nov;52(6):366-378. doi: 10.1024/0301-1526/a001093. Epub 2023 Oct 6.
The quality of vascular care has significantly improved in part by the expansion of endovascular techniques for the treatment of symptomatic peripheral artery disease (PAD) in recent years. In Germany these are primarily provided by the three disciplines of vascular surgery, angiology, and interventional radiology (IR). However, the relative contribute of angiologists to the total number of cases performed is unknown. In the present study, we analysed the respective contribution of vascular surgery, angiology, and IR to the delivery of endovascular revascularisations in symptomatic PAD in Germany based on the legally mandatory quality reports representative for the reporting year 2018. Vascular surgery is the most common speciality reporting procedures in German hospitals (n=579; 25.1%), followed by IR (n=264; 11.5%), angiology (n=189; 8.2%) and cardiology (n=17; 0.7%). The combination of vascular surgery and IR was reported in 202 (8.8%), vascular surgery and angiology in 167 (7.2%) and angiology and IR in 65 (2.8%) hospitals, and 63 (2.7%) hospitals reported the combination of all three disciplines. Not every department performed catheter interventions. The analysis of procedures per centre revealed that angiology centres provided the highest numbers for both basic procedures and more complex techniques such as atherectomy, rotational thrombectomy, lithoplasty, selective thrombolysis or the use of re-entry devices. In total, angiology centres provided 24.4% of the total procedures or 23.9% of the so-called basic procedures as a surrogate for patient numbers. While each of the disciplines contribute significantly to the endovascular procedures, angiology centres perform more procedures per centre and more complex procedures than the other disciplines highlighting the important quantitative and qualitative contribution of angiology specialists to the care of vascular patients. The inpatient catheter interventional care of patients with PAD is still too rarely carried out in a multi-disciplinary manner in Germany.
近年来，血管内技术的扩展在一定程度上提高了血管护理质量，用于治疗有症状的外周动脉疾病 (PAD)。在德国，这些主要由血管外科、血管内科和介入放射学 (IR) 这三个学科提供。然而，血管内科医生在已执行病例总数中的相对贡献尚不清楚。在本研究中，我们根据 2018 年具有法律强制性的质量报告，分析了血管外科、血管内科和 IR 在德国有症状 PAD 血管内血运重建中的各自贡献。血管外科是德国医院报告程序最常见的科室（n=579；25.1%），其次是 IR（n=264；11.5%）、血管内科（n=189；8.2%）和心脏病学（n=17；0.7%）。202 家医院（8.8%）报告了血管外科和 IR 的联合治疗，167 家医院（7.2%）报告了血管外科和血管内科的联合治疗，65 家医院（2.8%）报告了血管内科和 IR 的联合治疗，63 家医院（2.7%）报告了三个科室的联合治疗。并非每个科室都进行了导管介入治疗。对各中心开展的手术进行分析后发现，血管内科中心提供了数量最多的基本手术和更复杂的技术，如旋切术、旋转血栓切除术、碎石术、选择性溶栓或使用再入装置。总的来说，血管内科中心提供了 24.4%的总手术量，或作为患者数量替代指标的 23.9%的基本手术量。虽然每个学科都对外科血管内手术有显著贡献，但血管内科中心的每例手术数量和更复杂的手术数量均多于其他学科，突出了血管内科专家对血管患者护理的重要数量和质量贡献。德国的 PAD 患者住院经皮导管介入治疗仍很少以多学科的方式进行。
