Current practices in training of open lower extremity revascularization

After the publication of the BEST-CLI trial results, there has been a renewed emphasis on the importance of open lower extremity procedures in the practice of vascular surgery. As endovascular procedures have increased in volume, vascular surgery trainees are expected to be equally well-trained in both endovascular and open techniques. Certification in vascular surgery by the American Board of Surgery does not currently require a technical assessment. Rather, board certification is based on a combination of a written examination, oral examination, and review of case logs during training. As endovascular techniques have become more prominent, there has been a greater variety of techniques and equipment for trainees to master within the same duration of subspecialty training. Considering developments in the training paradigm such as work hour restrictions and the advent of the primary certificate in vascular surgery, ensuring that trainees have sufficient exposure to concepts in open peripheral vascular surgery is crucial. Various educational techniques are currently used to supplement intraoperative learning.