Remembrance of things past--New England surgeons and infrainguinal reconstruction.

Abstract

As I look back on a surgical career spent largely in New Engjand, I am struck by the contributions that have been made by New England surgeons to the development of many aspects of our specialty of vascular surgery. I have chosen to talk about only one of these aspects today--infralngUinal arterial reconstruction---becanse I believe more New England surgeons have been responsible for substantial advances in this area of vascular surgery than any other. These remarks will reflect a personal perspective only, and I have not attempted to do an exhaustive literature search on this subject. You will undoubtedly find that I have missed important contributors. For the purpose of this discussion and without asldng anyone's permission, however, I have claimed as New England surgeons those who received their surgical training in this region as well as those who practice or practiced surgery here. Although autogenous saphenous vein grafts had been used in a few instances to replace popliteal aneurysms in the early part of the 20th century, it was not until the 1940s, when both angiography and heparin were available, that treatment of occlusive disease in the arteries of the leg was begun, first by Dos Santos with endarterectomy 1 and shortly thereafter by Kunlin with reversed saphenous vein grafts. 2 Both