Vascular surgery

Recent developments in vascular surgery have occurred in many areas. The topics of intimal hyperplasia and reperfusion injury are the subject of much current research and possible methods of treatment are at an early stage of development. Advances in perioperative care have contributed to a reduction in mortality and morbidity. Endovascular techniques are being employed widely but the indications for their use are not yet agreed. The laboratory assessment of patients has been enhanced by the availability of duplex ultrasound scanning. The indications for carotid endarterectomy are becoming less controversial and a more aggressive approach is being taken in patients with abdominal aortic aneurysm. In patients with chronic lower limb ischaemia, long bypass grafts to the level of the ankle are being performed more frequently. The use of temporary shunts in patients with major arterial injuries appears to improve the results of treatment.