Vascular Surgery

Vascular Surgery

Vascular Surgery focuses on the diagnosis and operative management of arterial and venous disease outside the heart and brain. CSTs in vascular surgery support open, hybrid, and endovascular procedures used to treat aneurysms, occlusive disease, embolic events, trauma, and venous disorders. This specialty requires mastery of delicate vascular instruments, graft materials, endovascular devices, and sterile technique during high‑acuity cases involving major vessels and hemorrhage control.

Role of CSTs

  • Prepare vascular instrument sets, endovascular tools, and specialty trays for arterial and venous procedures.
  • Assist with patient positioning, prepping, and draping for open, hybrid, and endovascular access.
  • Maintain sterile technique during procedures involving major vessels and high‑risk bleeding.
  • Anticipate surgeon needs during exposure, clamping, grafting, and endovascular deployment.
  • Manage guidewires, catheters, sheaths, balloons, and stent graft systems.
  • Support fluoroscopy‑guided workflows during endovascular repairs.
  • Handle specimens such as thrombus, plaque, or bypass graft segments with proper labeling.
  • Assist with accurate counts and efficient turnover during long, multi‑stage vascular cases.

Essential Skills

  • Strong understanding of arterial and venous anatomy.
  • Proficiency with vascular clamps, graft tools, and endovascular devices.
  • Ability to anticipate surgeon needs during vessel exposure, clamping, and repair.
  • Skilled in handling guidewires, catheters, and stent graft systems.
  • Competence with fluoroscopy workflows and radiation‑safe practices.
  • Ability to maintain sterile technique during high‑acuity hemorrhage control.
  • Effective communication with surgeons, anesthesia, and radiology teams.
  • Familiarity with hybrid OR workflows and endovascular imaging.

Common Procedures

  • Open abdominal aortic aneurysm (AAA) repair
  • Endovascular aneurysm repair (EVAR/TEVAR)
  • Carotid endarterectomy
  • Femoral, popliteal, or tibial bypass
  • Arteriovenous fistula creation for dialysis
  • Thrombectomy or embolectomy
  • Peripheral angioplasty and stent placement
  • Endarterectomy of peripheral vessels
  • Varicose vein procedures
  • Vascular trauma repair
  • Hybrid procedures combining open and endovascular techniques

Instruments & Equipment

Instruments

  • Vascular clamps (DeBakey, Satinsky, Fogarty)
  • Aortic and peripheral vascular sets
  • Graft instruments and tunneling tools
  • Fogarty catheters for thrombectomy
  • Microvascular instruments for delicate repairs
  • Hemostatic tools and pledgeted sutures
  • Endarterectomy instruments
  • Vessel loops, umbilical tapes, and bulldog clamps

Equipment

  • Fluoroscopy/C‑arm imaging
  • Endovascular stent graft systems
  • Guidewires, sheaths, and catheters
  • Balloon angioplasty devices
  • Electrosurgical generators
  • Suction and irrigation systems
  • Warming devices for long vascular cases
  • Hybrid OR imaging platforms

Workflow & Case Progress

  1. Room setup with vascular instruments, graft materials, and endovascular equipment.
  2. Patient positioning based on open or endovascular approach.
  3. Prepping and draping with attention to large‑vessel exposure or access sites.
  4. Initial incision or percutaneous access under fluoroscopy.
  5. Vessel exposure, clamping, or endovascular navigation.
  6. Repair, grafting, or stent deployment depending on pathology.
  7. Hemostasis, flow restoration, and imaging verification.
  8. Closure of incisions or access sites.
  9. Final counts and transfer to PACU or ICU with detailed handoff.

Sterile Technique Considerations

  • Maintain strict sterile technique during high‑risk bleeding and vessel exposure.
  • Protect the sterile field during fluoroscopy and imaging adjustments.
  • Handle guidewires and catheters without contaminating the sterile field.
  • Maintain sterility during hybrid OR workflows with multiple teams.
  • Manage grafts and biologic materials with sterile precision.
  • Ensure sterile technique during conversions from endovascular to open repair.

Career Pathways

  • Vascular Surgical Technologist
  • Endovascular Specialist
  • Hybrid OR Technologist
  • Vascular First Assist (with additional training)
  • Clinical educator for vascular instrumentation
  • Device representative for stent graft and endovascular platforms
  • Dialysis access technologist

How to Prepare

  • Study arterial and venous anatomy, aneurysm pathology, and occlusive disease.
  • Learn vascular clamp types, graft materials, and endovascular device functions.
  • Practice handling guidewires, catheters, and stent graft systems.
  • Review workflows for EVAR, open AAA repair, and peripheral bypass.
  • Observe vascular cases to understand pacing and imaging‑guided navigation.
  • Strengthen sterile technique for high‑acuity vascular procedures.
  • Build familiarity with hybrid OR equipment and fluoroscopy workflows.