Building a partnership between vascular medicine and vascular surgery : A coalition for the future of vascular care

Cardiovascular diseases are the most common cause of morbidity and mortality in the United States. Remarkable growth has occurred in the medical community regarding the recognition, understanding, and treatment of these diseases. This growth has been skewed, however, because most of the available resources have been directed toward the diagnosis and therapy of coronary artery disease. The impact that peripheral vascular diseases have on our national health is now receiving increased attention, but it is critical that strategies for the prevention, diagnosis, and treatment of these diseases be improved. Peripheral vascular diseases (noncardiac circulatory disorders) are highly prevalent in the United States. For example, peripheral arterial disease (PAD) affects 10% to 12% of the adult population. 1,2 Approximately one third of persons with PAD have clinically significant symptoms in their legs (e.g., claudication, rest pain, or nonhealing wounds) that severely impair daily walldng, ambulatory activities, and vocation. ~-s Thus PAD is a major cause of disability in the United States. Despite the association of peripheral atherosclerosis with a markedly increased risk of cardiovascular mortality, there is little awareness of the pathogencsis, natural history, and