The Impact of Vascular Surgery Procedures on Climate Change
Mingxue Wang, MD, Fares Al-Khouja, MD, Arianne Johnson, PhD, Jasmine Lin, BS, and
Kevin M. Casey, MD, Santa Barbara, CA
ABSTRACT
Background: If the health care sector were an independent nation, it would be the 5th largest greenhouse gas (GHG) emitter in the world, with operating room waste (ORW) being a significant contributor. However, the specific impact of ORW from vascular surgery procedures remains under-examined. The objective of this study was to examine and compare the ORW produced from open, endovascular, and hybrid vascular procedures.
Methods: A single-center, prospective, observational review was performed examining all vascular procedures over a 6-month period. ORW was measured after each procedure and divided into 3 categories: disposable, biohazard, and recycling. GHG emissions were then calculated based on established measurements.
Results: A total of 367 procedures were performed by 3 vascular surgeons at one institution. There was a 93% compliance with data collection by the OR teams. Of these, 329 procedures met criteria for inclusion for analysis: 143 (43%) endovascular, 146 (44%) open, and 40 (12%) hybrid procedures. The mean ORW produced per procedure was 8.36 kg. Total ORW was signi cantly higher for hybrid procedures (11.6 kg) than for endovascular (8.15 kg; P < .001) or open procedures (7.68 kg; P < .001). Endovascular procedures produced signi cantly more biohazard waste (1.64 kg) and recyclable waste (1.23 kg) compared with open procedures (1.15 kg; P < .05 and .44 kg; P < .001). However, open procedures produced significantly more disposable waste (6.09 kg) compared with endovascular (5.18 kg; P < .001). Hybrid procedures produced significantly more biohazard waste (3.09 kg; P< .001) and disposable waste (7.27 kg; P< .001) compared with open procedures.
Conclusions: Endovascular and hybrid vascular procedures produced signi cantly more biohazard waste compared with open vascular procedures. Biohazard waste creates up to 3 times the GHG production compared with nonbiohazard ORW. Although the health care sector must identify numerous ways to reduce its carbon footprint, the identification and reduction of waste, particularly biohazard waste, will help to decrease the carbon footprint in the increasingly prominent endovascular realm. (JVS-Vascular Insights 2025;3:100252.)
Keywords: Climate change; Vascular surgery procedures; Greenhouse gas emissions; Sustainability
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