The role of vascular expertise in endovascular therapy: Impact of operator specialty, procedural volume, and multidisciplinary care

Endovascular surgery is increasingly utilized as a minimally invasive strategy in the management of aortic aneurysms and peripheral arterial diseases. Operator specialty, institutional procedure volume, and multidisciplinary care models are critical factors influencing patient outcomes, healthcare costs, and care pathways. This review evaluates the performance of vascular surgeons, interventional cardiologists, and interventional radiologists, contextualized by crucial confounders such as hospital volume, referral bias, and patient complexity. Current evidence demonstrates that procedures performed in high-volume centers, supported by multidisciplinary vascular teams, optimize clinical safety, long-term durability, and cost-effectiveness across all specialties.