Gefässchirurgie : Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie

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BACKGROUND: Over the past 30 years the number of hospitals in Germany has fallen by 21% and the number of hospital beds by 27%. During the same period the average length of stay in hospitals has halved. Nevertheless, the system efficiency is too low. OBJECTIVE: The causes of the system inefficiency in the German hospital sector and approaches for a hospital reform are presented. MATERIAL AND METHODS: The official statistics were analyzed and a summary of fundamental works, studies and expert recommendations is given in a review article...

INTRODUCTION: The demographic development in Germany, especially in Saxony-Anhalt (SA), also poses challenges for vascular surgery, as the incidence of vascular diseases has increased following demographic change. For example, the prevalence of peripheral arterial occlusive disease (PAOD) in industrialised countries is estimated at around 10-20% in people over 60 years of age; thus, the number of people affected will also increase here with demographic change. Especially in rural areas, it seems to be more difficult for patients to reach appropriate specialist treatment...

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Apart from daily clinical work and patient care, research and student teaching are essential assignments of a university hospital. The implementation of a completely new research laboratory at the Department of Vascular Surgery at the Medical University of Innsbruck led to the creation of a novel infrastructure for the design and set-up of a newly founded research focus. The cooperation with national as well as international research collaborators was essential for this process. The construction of a research network is not only important for the design and conception of a new research laboratory but also for the development of new study protocols and exchange and discussion of results...

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Although patients with peripheral arterial disease (PAD) are at a high risk of major bleeding owing to their comorbidity and risk profile, no validated tools exist to predict bleeding risk. To make matters worse, several randomized and controlled trials have excluded patients who are at a high risk of bleeding. Using routine health insurance claims data and machine learning methods, a pragmatic prediction model was developed and internally validated. The OAC3 -PAD risk score identified eight variables that can predict major bleeding events within 1 year of inpatient treatment for PAD...

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The establishment of new surgical methods and techniques is associated with a learning curve which can lead to a higher morbidity and mortality for patients during training. To counteract this problem, within the framework of surgical and endovascular training and to transfer the learning curve from the patients to the simulator, life-like models are used and tested. The benefits of such simulator training have been shown in multiple disciplines. This article presents the steps from the conception to the production and validation of a simulator for ultrasound-guided arterial and venous puncture...

One of the main risk factors for the presence of carotid stenosis and carotid-related stroke is age. The aim of this review article is to present the current state of knowledge on age-related vascular changes using carotid stenosis as an example.Vascular aging (vascular senescence) is a decrease of structural and functional properties of the vessel wall that takes place on different levels. At the multicellular level an increase in vessel volume and diameter as well as intima media thickness occurs with age mainly due to atherosclerotic changes in the vessel wall...

Background: Vessels are not frequently affected in traumatology and isolated vascular trauma (VT) is rare; therefore, there is a lack of reliable and current data on the incidence and mortality. Objective: This article reports on the status of VT in trauma care of the severely injured in Germany based on selected references and data from our own published analyses and current studies from the data of the TraumaRegister DGU® (TR-DGU). Material and methods: Selected review of the literature and report on 2 retrospective assessments of datasets of the TR-DGU...

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BACKGROUND: COVID-19 resulted in postponement and cancellation of elective operations in all surgical disciplines worldwide, especially in the first weeks of the pandemic. The specific situation in vascular surgery clinics in Germany during this period has not yet been described. OBJECTIVE: The purpose of the survey was to record the provision of vascular surgery services in the period from March 2020 to December 2020 as well as logistical and infrastructural changes that resulted from the pandemic situation...

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People suffering from rare diseases are optimally treated in specialized centers with an interdisciplinary and multiprofessional team. These centers are also actively involved in research and provide all levels of teaching and education with respect to a single disease or a group of diseases. In Germany, there are now more than 30 reference or so-called type A centers for rare diseases located at university hospitals, which undertake these tasks with their associated disease (group)-specific type B or specialist centers...

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Increasing age and comorbidities as well as the duration of chronic dialysis make it difficult to establish and maintain a functioning vascular access in patients with terminal kidney failure. The risk of a central venous stenosis or occlusion is greatly increased with a central venous catheter and cardiological or oncological interventions. The implantation of the Hemodialysis Reliable Outflow (HeRO®) graft (Merit Medical Systems Inc., South Jordan, UT, USA) is meanwhile an established combined interventional/surgical procedure for restoration of the stenosed or occluded venous outflow...