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personal protective equipment, elective surgical practice, changes in call schedule, and redeployment to nonvascularsurgery duties were also included in the survey. Regional variation was assessed. The survey data were collected usingREDCap and analyzed using descriptive statistics.Results:A total of 535 vascular surgeons responded to the survey from 45 states. Most of the respondents were male(73.1%), white (70.7%), practiced in urban settings (81.7%), and in teaching hospitals (66.8%). Almost one-half were inhospitals with more than 400 beds (46.4%). There was no regional variation in the presence of preoperative COVID-19testing, COVID-19 OR protocols, adherence to national surgical standards, or the availability of personal protectiveequipment. The overwhelming majority of respondents (91.7%) noted elective surgery cancellation, with the Northeastand Southeast regions having the most case cancellations 94.2% and 95.8%, respectively. The Northeast region reportedthe highest percentage of operations or procedures on patients with COVID-19, which was either identified at the time ofthe surgery or later in the hospital course (82.7%). Ambulatory visits were performed via telehealth (81.3%), with 71.1%having restricted hours. More than one-half of office-based laboratories (OBLs) were closed, although there was regionalvariation with more than 80% in the Midwest being closed. Cases performed in OBLs focused on critical limb ischemia(42.9%) and dialysis access maintenance (39.9%). Call schedules modifications were common, although the number ofcall days remained the same (45.8%).Conclusions:Vascular surgeons in the United States report substantial impact on their practices during the COVID-19pandemic, and regional variations are demonstrated, particularly in OBL use, intensive care bed availability, andCOVID-19 exposure at work. (J Vasc Surg 2021;73:772-9.)Keywords:COVID-19; elective vascular surgery; vascular surgery practice;financial stress; occupational exposure; personalprotective equipment; pandemic; OBLThe global pandemic of coronavirus disease 2019(COVID-19) has led to unprecedented cancellation of elec-tive surgeries in the United States and has posed a signifi-cant strain on thefinances of health care systems. A recentreport by the CovidSurg Collaborative projects that 28.4million elective surgeries worldwide will be canceled orpostponed in 2020.1During the height of the pandemic,tier classifications of surgical procedures were created tostratify the urgency of operations. The goals of these clas-sification systems were to maintain optimal patientFrom the Division of Vascular & Endovascular Surgery, McLaren Health System,Bay Citya; the Division of Vascular Surgery, Michigan State University, Lansingb;the Division of Vascular Surgery, University of California Los Angeles, Los Ange-lesc; the Division of Vascular Surgery and Endovascular Therapy, The Univer-sity of Colorado, Anschutz Medical Center, Aurorad; the New York/Presbyterian Weill Cornell School of Medicine, New Yorke; the Vascular Sur-gery, Spectrum Health Medical Group, Grand Rapidsf; the Department of Sur-gery, University of Michigan, Ann Arborg; the Department of CardiovascularSurgery, University of Texas at Houston, Houstonh; the Division of Vascularand Endovascular Surgery, Louisiana State University Health Sciences Center,New Orleansi; and the Division of Vascular Surgery, Department of Surgery,University of Washington, Seattle.jAuthor conflict of interest: none.Additional material for this article may be found online atwww.jvascsurg.org.Correspondence: Sherene Shalhub, MD, MPH, FACS, Division of Vascular Sur-gery, Department of General Surgery, The University of Washington, 1959NE Pacific St, Box 356410, Seattle,
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