[The best of vascular pathology in 1999]

In vascular pathology, the discovery of the ABC1 receptor (ATP-binding-cassette transporter 1), the deficit of which is responsible for Tangier disease and familial hypoalphalipoproteinaemias, has opened the greatest perspectives with the possibility of new active treatments in the prevention of atherosclerosis. Other advances were more expected. A large British trial convincingly demonstrated that the follow-up of small abdominal aortic aneurysms is reliable. The MEDENOX trial showed the value of prophylaxis of thromboembolic disease in a medical setting and the reduced incidence of phlebographic events. The ICAI study, on the other hand, showed the difficulty of treatment of critical ischaemia of the lower limbs: alprostadil (PGE1) was ineffective with a 6 month follow-up in this pathology. Finally, low dose aspirin is at least as effective as high doses.