血管学: オープンアクセス
オープンアクセス

概要

Prosthetic Vascular Access Creation: Learning Curve Analysis

Franchin M*, Tozzi M, Mozzetta G, Cervarolo MC, Nahal E, Carcano G and Piffaretti G

Aim: In the present study, we analysed the learning curve of prosthetic vascular access creation. Materials and methods: The first 50 consecutive prosthetic vascular access created by a single experienced vascular surgeon was included in this study. Primary outcomes were operative time, intervention-free access survival and functional access survival. Additional outcomes were complications of the intervention. We used the cumulative sum technique to assess the learning curve.
Results: The analysis of the learning curve obtained with cumulative sum technique on operative time, interventionfree survival and functional access survival permitted to define three phases: learning (first 25 patients), expertise (following 15 patients) and post-learning phase. Accordingly, statistical differences were observed in operative time, intervention-free survival, and frequencies of graft thrombosis among the three groups.
Conclusion: Prosthetic vascular access creation is a safe and effective intervention when performed by an experienced vascular surgeon. Otherwise, a twenty-five interventions learning curve is mandatory to obtain better results in terms of operative time, circuit survival and frequency of thrombosis. Additional fifteen interventions are required to obtain an expert level of practice, allowing for more challenging procedure.