Rationale, Status und Ausblick der vaskulären Registerstudien der DGG

Background and purpose: This overview presents the objectives of some vascular registries of the German Society for Vascular Surgery and Vascular Medicine (GSVS) and describes perspectives for the future. Material and results: The importance of the registration of inhospital mortality of patients with ruptured abdominal aortic aneurysm (rAAA) for whom corrective aneurysm treatment can no longer be provided is explained and the rationale for the distinction between hemodynamically stable and instable patients with rAAA is given. The registration of the structural quality of treatment centers is proposed because it was clearly shown that the structural quality might have an influence on the quality of results. The CRITISCH registry study has the aim of describing the treatment situation in patients with critical limb ischemia (CLI) and to evaluate endovascular and open repair with respect to long-term results, which in this registry are compared for the first time in Germany in a follow-up study. The POPART study for registration of endovascular and open treatment of popliteal artery aneurysms demonstrates the importance of register surveys for the evaluation of therapeutic strategies for rare diseases, which are difficult to evaluate in randomized trials due to the small numbers of cases. Therefore, limited guideline recommendations exist for the treatment of this disease. Discussion: A population-based evaluation of all treatment modalities can improve this situation; however, registry studies should not only deal with complication prone diseases but also have a role in interventions that are considered more or less free of major complications. An example is the varicose veins registry of the GSVS for which the current issues are described. The point of this registration should not only be the complication rate. With a procedure which can be performed largely on an outpatient basis the cost-effectiveness of outpatient and inhospital treatment has to be analyzed with respect to personnel and material expenditure. This is illustrated by the comparison of endovenous and traditional open surgical procedures.