Trends of vascular service in a well defined geographical area in 1990's

The treatment policy of vascular surgical patients has undergone changes in the last decade. The aim of this study was to evaluate development of vascular service in a well defined geographical area, the district of Tampere University Hospital.

This population based study is established on the vascular registry. During the eight year period (1990-1997) totally 5019 procedures had been registered, 3363 vascular surgical operations and 1656 endovascular interventions. This data was analysed retrospectively.

The annual amount of vascular surgical procedures was in average 959 per million inhabitants and the amount of endovascular procedures 474 per million inhabitants during the period and the trend was slightly increasing. The mean age of surgical patients increased significantly during the eight year period, from 63.6 to 66.6 years, while the mean age of endovascular patients remained fairly stable over the whole period. The proportion of critical limb ischaemia as an indication for surgical procedure increased during the period from 7.3% to 16.6% (p < 0.001). In the same time also the amount of femoropopliteal and femorodistal bypasses as a treatment of CLI increased significantly (p < 0.001). Further, the proportion of surgical procedures compared to the endovascular procedures in the treatment of CLI increased constantly over the 8-year period from 25% to 61% (p < 0.001). The absolute amount of access surgery increased over the period and the mean age of these patients increased significantly. The median of hospital stay decreased during the eight year period in the surgical group from 9 days to 6 days and in the endovascular group from 2 days to 1 day.

The main changes have been the increased mean age of patients, their shortened hospital stay and the increasing surgical activity on patients with CLI and the larger number of patients with need for vascular access.