A new paradigm: the vascular center

The vascular surgeon, in the absence of effective medical options for the treatment of atherosclerosis, has in the past assumed primary responsibility for the care of patients with peripheral vascular disorders. During the past two decades, management of these patients has become increasingly complex, the direct result of extraordinary proliferation of both our aging population and the expanding technological array of treatment options available. Such patients often require multiple medications with repeated encounters with a variety of specialists resulting in inefficient and not infrequently ineffective care. The concept of a truly integrated multidisciplinary effort to expedite the care of patients with peripheral vascular disease developed in the early 1980s. A vascular center was created at the Brigham and Women's Hospital involving the departments of Surgery, Medicine, and Radiology with their appropriate subspecialty divisions. The combined expertise of dedicated individuals interested in a disease-oriented perspective has resulted in a marked improvement in the efficiency and, it is hopeful, efficacy of management.