SRS215 - Calculating and reducing the environmental impact of hybrid endovascular surgery

Abstract The healthcare sector is a substantial contributor to global greenhouse gas emissions, with surgical services accounting for a significant proportion due to the use of single-use consumables, volatile anaesthetic agents, and energy-intensive infrastructure, including ventilation, lighting & climate control systems. This study quantified the carbon footprint of commonly performed arterial vascular procedures and identified modifiable drivers to reduce their environmental impact. A prospective observational study was carried out at a single vascular surgery centre, focusing on four procedure types: simple endovascular aneurysm repair (EVAR), complex EVAR, percutaneous lower limb revascularisation, and hybrid lower limb revascularisation. Real-time data were collected to capture devices, consumables, and waste associated with each intervention. A life-cycle assessment (LCA) approach quantified emissions across the product pathway, including raw material extraction, manufacturing, packaging, transportation, and disposal. Carbon emissions varied significantly between procedure types (Kruskal–Wallis test, H = 11.53, P < 0.05), with complex EVAR associated with the highest median emissions, reflecting greater resource intensity and procedural complexity. Median emissions for complex EVAR were equivalent to driving approximately 418 miles in a standard petrol vehicle. A strong positive correlation was seen between the number of theatre personnel and the volume of single-use wearable items (Spearman’s ρ = 0.878, P < 0.001), suggesting staffing levels contribute meaningfully to procedural waste. Opportunities to reduce emissions were identified, including use of percutaneous techniques, reusable surgical textiles, sustainable packaging strategies and imaging optimisation. This pilot study represents the first observational quantification of the carbon footprint associated with common arterial vascular procedures and identifies targets for sustainability interventions within vascular surgery.