GUEST
EDITORIAL
Over the years the speciality of vascular surgery had taken a back seat within
the broader speciality of Cardio-Vascular and Throacic surgery. The glamour
of the big brother cardiac surgery slowed down the development of the speciality
of vascular surgery as also the development of the ancillarys like grafts, instruments
and most of all awareness of its problems. Especially in India patients have
been losing limbs to gangrene unnecessarily over the years due to the dearth
of trained Vascular physicians. The clinical presentation and severity of diseases
like, Thromboangiitis obliterans Takayasu’s Pulseless disease, Diabetic Vasculitis
and even, Atherosclerosis is so different in India than what we see and read
about in Western Literature. The sheer magnitude of the problem of Vascular
Disease in India is staggering. Although we still don’t have an accurate vascular
registery the fact that there are over 25 million Diabetics in the country is
just a small pointer to the vast numbers of the undiagnosed Vascular cases.
Patients of severe vascular disease have been treated for low backache and arthritis
for years. It is only the onset of peripheral gangrene which brings to light
the fact that arterial pulsations have been absent for long periods of time
hitherto unnoticed. After diagnosis also the only treatment of these unfortunate
cases has been amputations leaving the primary vascular problem unsolved. It
is therefore upto the proponents of vascular surgery to perform the optimum
procedures on these patients in order to save limbs and so allow the patient
to continue his gainful occupation and continue to provide for his family.
It was with a view of increasing the awareness of vascular disease and to improve
the training and facilities available to Vascular surgeons that we formed a
Vascular Society of India in 1994.
Since it formation the Society has been conducting annual conferences with Workshops
involving foreign delegates in Mumbai (1995) Delhi (1996) Bangalore (1997) Ahmedabad
(1998) Hyderabad (1999) and Chennai (2000). It is a forum for interaction of
Vascular surgeons, Cardio Thoracic Surgeons, Radiologist and Cardiologist along
with Peripheral Vascular problems and other management. The Society has grown
6 fold from the original 30 to almost 200 numbers to date. It has started a
Fellowship training programme approved by the National Board of Examinations.
Historically Vascular reconstruction was first reported by Lambert in 1762 By
1882 Schede had done the first lateral vein repair. In 1877 Nikolac Eck did
the First Porto-Caval shunt in clogs. In 1899 Kummel performed the first end
to end anastomosis of an artery in a human. In 1906 Goyanes used a piece of
popliteal vein to repair an aneurysmal popliteal artery. The Golden Era of vascular
surgery began just after World War II.
Arterial homografts were introduced followed by various Dacron and PTFE grafts
used to replace and repair all diseased medium and large sized arteries. This
concomitant development of vascular suture materials, vascular instruments and
devices such as embolectomy catheters have progressed at an exponential rate.
Before I end I would like to thank Dr. TP Kulkarni the pioneer and best known
Vascular Surgeon in the country. He is a most skilled and experienced Vascular
Surgeon who has been associated with Bombay Hospital for over thirty years.
He planted the seed of Vascular Surgery in me and I would like to thank him
on behalf of the speciality of Vascular surgery and myself for keeping the Vascular
flag flying through all these difficult years.
Finally I do hope all the readers of this prestigious journal will enjoy some
of the articles in this issue by eminent Indian Vascular Surgeons and it will
spread more awareness of the specialty and its proponents among the medical
and lay community of this country at large.
DR. ANAND SOMAYA
Consulting Cardio-Thoracic and Vascular Surgeon
