Need For Vascular Surgery Research Articles

Reduction of requirement for leg vascular surgery during long-term treatment of claudicant patients with ticlopidine: Results from the swedish ticlopidine multicentre study (STIMS)

To study the effect of long-term treatment of the platelet inhibitor ticlopidine as secondary prevention against the need of vascular surgery in patients with intermittent claudication. The Swedish Ticlopidine Multicentre Study (STIMS), was conducted in six medical and surgical clinics of university hospitals in Sweden. 687 claudicants were randomised to ticlopidine 250 mg bd or placebo and vascular surgery events were recorded prospectively over a 7-year period. Cox proportional hazards models of risk for leg vascular surgery were constructed using drug treatment and 11 putative risk factors for vascular disease as covariates. Surgical event-free survivals were compared by Kaplan-Meier analysis. The overall rate of first operations was 2.4% per annum. More than half of these operations were in the aortoiliac region. One-quarter of patients operated during the period required further operations but amputation was rare. Ticlopidine treatment reduced the need for vascular reconstructive surgery by about half, both in intention-to-treat and on-treatment analyses (unadjusted relative risks 0.486, 95% CI 0.317-0.745; p < 0.001; 0.493, 95% CI 0.290-0.841: p < 0.01, respectively). In Cox model analysis only male sex was confirmed as a risk factor for surgery. Previous peripheral arterial surgery was the strongest predictor of the need for surgery. None of the risk factors examined interacted statistically with the effect of treatment with ticlopidine. In patients with intermittent claudication it seems possible to prevent the need for future vascular surgery by the use of platelet inhibition with ticlopidine.

European vascular surgery 1988. Increasing needs in an era of constrained economical resources

Dear members and guests: Let me first express my gratitude for the great honour of being elected as the first President of this distinguished society. It is with great pride that I see the number of members steadily increasing, and I think we all appreciate the importance of our society for the coordination of the various activities within vascular surgery in Europe today. In many European countries the number of vascular procedures has increased during recent years and particularly in the last decade there have been significant increases in most categories of vascular operations. In spite of this we are unable to fulfill the increasing needs of our patients. L 2 The number of elderly people in the population is increasing and it seems that there will be an increasing number of patients in the future who will need our services in order to prolong and improve the quality of life. However, as the need for vascular surgery has increased, hospital budgets have certainly not increased to the same extent. On the contrary, since the mid seventies, severe cutbacks have been common in most countries. ~'4's Medical care expenditure expressed as a percentage of gross national product has actually decreased during the last ten years, particularly in the allocation to