Vascular surgery

Vascular surgery is a surgical subspecialty in which diseases of the vascular system are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery as well as minimally-invasive techniques pioneered by interventional radiology. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system except those of the heart and brain. Cardiothoracic surgeons and interventional cardiologists manage diseases of the heart vessels. Neurosurgeons and interventional neuroradiologists surgically manage diseases of the vessels in the brain.

Scope
Vascular surgery encompasses surgery of the aorta, carotid arteries, and lower extremities, including the iliac, femoral, and tibial arteries. Vascular surgery also involves surgery of veins, for conditions such as May-Thurner syndrome and for varicose veins. In some regions, vascular surgery also includes dialysis access surgery and transplant surgery.

The main disease categories and procedures associated with them are listed below.

Training
Previously considered a field within general surgery, it is now considered a specialty in its own right. As a result, there are two pathways for training in the United States. Traditionally, a five-year general surgery residency is followed by a one to two year vascular surgery fellowship. An alternative path is to perform a five or six year vascular surgery residency.