Veith F J, Marin M L
Department of Surgery, Montefiore Medical Center and Albert Einstein College of Medicine, 111 East 210 Street, Bronx, New York 10467, U.S.A.
World J Surg. 1996 Jul-Aug;20(6):687-91. doi: 10.1007/s002689900104.
Endovascular treatment methods that are largely catheter/guidewire-based permit treatment of a variety of vascular lesions from remote access sites in a minimally invasive manner. Because these endovascular technologies have intrinsic appeal to patients and physicians, they may, if proved safe and effective, replace a substantial proportion of current vascular surgical procedures. This change will have a substantial impact on the specialties involved in their development and use, that is, vascular surgery and interventional radiology (which in this discussion includes other interventional specialists devoted to peripheral vascular disease management). The relationship between these previously distinct specialties must also be influenced greatly by the introduction of endovascular technologies, the use of which requires skills that overlap the specialties. This paper considers several possible approaches for dealing with the altered interspecialty relationships that will result if new endovascular treatment methods prove to be safe and effective. Because the development and use of these endovascular technologies require the skills and talents of vascular surgeons and interventional radiologists (or other interventionalists), a collaborative, multispecialty approach to the use of endovascular technologies is recommended as the most reasonable and optimal for patient care. Although this approach may not be applicable for every environment, it is the one most likely to minimize costs and turf battles, particularly if interspecialty conflict can be minimized by collaboration and compromises developed by a conjoint executive committee representing the leadership of the involved specialty societies.
主要基于导管/导丝的血管内治疗方法能够以微创方式从远程接入部位治疗各种血管病变。由于这些血管内技术对患者和医生具有内在吸引力，如果被证明安全有效，它们可能会取代相当一部分当前的血管外科手术。这一变化将对参与其开发和使用的专业领域，即血管外科和介入放射学（在本讨论中包括其他致力于外周血管疾病管理的介入专家）产生重大影响。血管内技术的引入也必然会极大地影响这些以前截然不同的专业之间的关系，因为其使用需要重叠这些专业的技能。本文考虑了几种可能的方法，以应对如果新的血管内治疗方法被证明安全有效而导致的专业间关系的改变。由于这些血管内技术的开发和使用需要血管外科医生和介入放射科医生（或其他介入专家）的技能和才能，因此建议采用协作性的多专业方法来使用血管内技术，这对患者护理来说是最合理和最佳的。尽管这种方法可能不适用于每种环境，但它是最有可能降低成本和减少地盘之争的方法，特别是如果通过代表相关专业协会领导层的联合执行委员会通过协作和妥协能够将专业间冲突降至最低的话。
