Current Challenges in Peripheral Vascular Surgery: Traditions in Transition

Abstract

The field of peripheral vascular surgery is changing as a result of many forces, including altered disease demographics, advances in technology, encroachment by competing specialties, evolution of training programs, governmental and reimbursement controls, and changing public expectations. The gradual evolution of program content of the annual meetings of the North American Chapter of The International Society for Cardiovascular Surgery for the past 20 years and the challenges for the future of vascular surgery in the USA are reviewed. During the past 20 years, 455 scientific papers and 20 presidential addresses were delivered to the North American Chapter. Papers on peripheral arterial and cerebrovascular disease have remained constant in number. Venous and cardiac contributions have declined in number and are covered in other societal meetings. Vascular radiologic interventions, diagnostic technology and research presentations have filled the void. Other topics, including epidemiology, manpower, outcomes, economics and governmental relations, have increased in number. The presidential addresses, while including topics of historical and clinical interest, have increasingly emphasized educational and socioeconomic issues. Vascular surgery, like other disciplines, is a dynamic specialty. As with medicine in general in the USA, this specialty will be increasingly challenged by socioeconomic pressures, which will lead to new issues that have not previously been addressed in the Chapter program, including preventive medicine and health services research.