Overview and Objectives of the Vascular Surgery Curriculum
Trainees in Vascular Surgery will undergo core training (CT1-2) followed by a period of 6 indicative years of specialty training (ST3-ST8). The purpose of this curriculum is to train vascular surgeons up to CCT level who will be able to work independently and to the standard of a consultant or equivalent. As such, most of their skills will relate to the management of 'everyday' vascular elective and emergency surgery and this forms the basis of the curriculum, with the competencies, both non-operative and operative being completed by the final year of training. This curriculum also allows a degree of flexibility to respond to the changing needs of our patients and the development of new models of healthcare delivery, and to incorporate technological advances, particularly in the endovascular field. The syllabus includes elective and emergency Vascular Surgery topics which need to be completed by all trainees to enable them to manage the conditions listed in the Scope and Standards of Vascular Surgical Practice key topics.
The syllabus also includes specific competencies in elective and emergency gastro-intestinal surgery to complement the management of intra-abdominal vascular conditions and these will normally be obtained during one indicative year of upper and lower gastro-intestinal surgery to be undertaken during intermediate training in ST3/ST4.
Some complex vascular and endovascular procedures are performed in only a few specialised centres and so do not require every trainee to reach a stage of full competence by the time of CCT. It is expected that trainees wishing to work in such centres will seek further experience and mentorship after CCT, although all trainees will be expected to have knowledge of these procedures so that they can initiate appropriate referral to a specialist centre.
Vascular FRCS papers
Below are links to 20 papers recommended for the Vascular FRCS:
Carotid Disease
GALA Trial Collaborative Group General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. Lancet. 2008;372:2132–2142.
Reanalysis of the final results of the European Carotid Surgery Trial. Rothwell PM et al. European Carotid Surgery Trialist's Collaboration. Stroke. 2003 Feb;34(2):514-23.
Early Endarterectomy Carries a Lower Procedural Risk Than Early Stenting in Patients With Symptomatic Stenosis of the Internal Carotid Artery: Results From 4 Randomized Controlled Trials. Rantner B et al. Carotid Stenosis Trialists’ Collaboration. Stroke. 2017 Jun;48(6):1580-1587.
Aortic disease
Mid-term Migration and Device Failure Following Endovascular Aneurysm Sealing with the Nellix Stent Graft System - a Single Centre Experience. Harrison SC et al. Eur J Vasc Endovasc Surg. 2018 Sep;56(3):342-348.
Systematic review and meta-analysis of sex differences in outcomes after endovascular aneurysm repair for infrarenal abdominal aortic aneurysm. Liu Y et al. J Vasc Surg. 2020 Jan;71(1):283-296
Multicentre Aneurysm Screening Study Group. Multi centre aneurysm screening study (MASS): cost effectiveness analysis of screening for abdominal aortic aneurysms based on four year results from randomised controlled trial. Multi centre Aneurysm Screening Study Group. BMJ. 2002;325: 1135-1139
Endovascular or open repair strategy for ruptured abdominal aortic aneurysm:30 day outcomes from IMPROVE randomised trial. IMPROVE Trial Investigators. BMJ. 2014; 348: 7661-7673
Randomised comparison of strategies for Type B dissection: the Investigation of STEnt grafts in Aortic Dissection (INSTEAD) Trial. Nienaber et al. Circulation. 2009; 120:2519-2528.
Meta-analysis of fenestrated endovascular aneurysm repair versus open surgical repair of juxtarenal abdominal aortic aneurysms over the last 10?years. Jones AD et al. BJS Open. 2019 May 17;3(5):572-584.
Peripheral Vascular Disease / Diabetic Foot Ulcer / Amputation
Risk of major amputation in patients with intermittent claudication undergoing early revascularization. Golledge J et al. Br J Surg. 2018 May;105(6):699-708.
Bypass versus angioplasty in severe ischaemia of the leg (BASIL): multicentre, randomised controlled trial. Basil Trial Participants. Lancet. 2005; 366:1925-1934.
Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Katsanos K et al. J Am Heart Assoc. 2018 Dec 18;7(24):e011245.
Lower limb amputation in England: prevalence, regional variation and relationship with revascularisation, deprivation and risk factors. A retrospective review of hospital data. Ahmad N et al. J R Soc Med. 2014 Dec;107(12):483-9.
The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). Mills JL Sr et al. Society for Vascular Surgery Lower Extremity Guidelines Committee. J Vasc Surg. 2014 Jan;59(1):220-34.e1-2.
Secondary Prevention in Peripheral Vascular Disease
MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20,536 high risk individuals: a randomised placebo-controlled trial. Heart Protection Study Collaborative Group. Lancet. 2002; 360; 7-22.
Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. Rivaroxaban with or without aspirin in patients with stable peripheral or carotid artery disease: an international, randomised, double-blind, placebo-controlled trial. COMPASS Investigators. Lancet. 2017 Nov 10. pii: S0140-6736(17)32409-1.
Venous Disease
Pharmacomechanical Catheter-Directed Thrombolysis for Deep-Vein Thrombosis. Vedantham S et al. ATTRACT Trial Investigators. N Engl J Med. 2017 Dec 7;377(23):2240-2252.
Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial. Gohel MS, Barwell JR, Taylor M, Chant T, Foy C, Earnshaw JJ, Heather BP, Mitchell DC, Whyman MR, Poskitt KR. BMJ. 2007 Jul 14;335(7610):83.
A randomized trial comparing treatments for varicose veins. Brittenden J, Cotton SC, Elders A, Ramsay CR, Norrie J, Burr J, Campbell B, Bachoo P, Chetter I, Gough M, Earnshaw J, Lees T, Scott J, Baker SA, Francis J, Tassie E, Scotland G, Wileman S, Campbell MK. N Engl J Med. 2014 Sep 25;371(13):1218-27.
A Randomized Trial of Early Endovenous Ablation in Venous Ulceration. EVRA Trial Investigators N Engl J Med. 2018 May 31;378(22):2105-2114.