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Evolution Of Vascular Surgery Research: Trends, Implications, And Future Directions Over Three Decades
Mark Basilious, BS, Michael Mazzucco, BS, Nakia Sarad, DO, Nitin Jethmalani, MD, Christopher Agrusa, MD, Sharif Ellozy, MD, Brian DeRubertis, MD, Peter Connolly, MD.
Weill Cornell Medical College, New York, NY, USA.

Figure 1: Publication volume over time by broad pathology group (logarithmic scale). Objective: This study aims to analyze trends in vascular surgery research over the past three decades to identify shifts in research focus, treatment modalities, and potential implications for the future. Methods: We analyzed 28,931 original publications in the MEDLINE database from eight dedicated vascular surgery journals from January 1992 to August 2023. Publications were analyzed using algorithmic text mining. This review was facilitated through the utilization of the "rentrez" R package—an application programming interface to the extensive MEDLINE database. Publications were categorized by treatment modalities (endovascular vs. open) and broad pathology groups (aortic pathology, carotid disease, peripheral arterial disease, venous disease, etc.). Further subgroup analysis was conducted to analyze aortic focused research by segment (ascending thoracic, descending thoracic, thoracoabdominal, abdominal) as well as treatment modalities for carotid artery stenosis (endarterectomy, carotid artery stenting, TCAR). Linear regression, correlation analysis, and graphical representations were employed for trend analysis. Results: Research output displayed exponential growth, with 50.8% of publications emerging in the last decade. Endovascular intervention-focused research surpassed open interventions since 2007. Aortic pathology was the most addressed topic, with peripheral arterial disease, carotid disease, and venous pathology closely following. These four topics represented 90.9% of all pathology specific publications. Peripheral arterial disease research exhibited the fastest growth (R=0.96). Subgroup analyses revealed increasing interest in ascending thoracic and thoracoabdominal aortic pathology. Carotid artery stenting has been the most researched treatment modality for carotid artery disease (51.8%), closely followed by carotid endarterectomy (41.9%). TCAR research experienced notable and rapid growth in recent years. Conclusions: Vascular surgery research has grown exponentially over the past three decades, reflecting the evolving landscape of endovascular interventions and the emergence of specific pathology areas. Increasing research in complex areas like thoracoabdominal pathology and treatments for carotid artery disease underscores the field's advancements. Despite persistent workforce shortages, the field’s research output continues to grow to meet the demands of an expanding patient population. Here we have demonstrated valuable insights for understanding the dynamic nature of vascular surgery research and its implications for the future.
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