Abstract
The practice of endovascular surgery is significantly enhanced by the use of a programmatic approach. Our goal as vascular specialists is to integrate endovascular techniques and concepts into vascular practice in the same way that we have integrated the medical and perioperative management of vascular patients into clinical care. In the not too distant future, the concept of vascular “surgery” is not likely to be independently functional. The most effective vascular specialists will be those who provide a full spectrum of management options that includes prevention, medical management, endovascular therapy, and open surgery; striving for the seamless care of patients with vascular problems. Vascular disease management appears to be approaching a stage in which endovascular surgery will be the treatment of choice for most situations that require mechanical intervention, with open surgery reserved for endovascular failures and those patients with the absolute worst disease morphology. Endovascular techniques have dramatically influenced the care of disease in every vascular bed. The opportunity to relieve suffering, reduce morbidity, and treat threatening illness with minimally invasive approaches is a privilege.
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