Emergency vascular surgery

The services of vascular specialists are in demand to treat common vascular emergencies—patients with acute ischaemia of the limbs and leaking aortic aneurysms.1 2 3 4 The management of these problems has become increasingly complex, often involving a team approach with specialists in interventional vascular radiology.1 General surgeons who do not perform elective arterial surgery have become concerned about dealing with difficult vascular emergencies because clinical governance will no longer support surgeons practising outside their normal sphere of work. The public expects treatment by specialists, and in vascular emergencies this is justified by outcome data.1 2 3 4 Unfortunately, there are not enough vascular surgeons to provide formal emergency rotas in most hospitals, and the number required would far exceed those needed to do the elective vascular work. Many vascular surgeons have provided informal emergency cover at the expense of their family lives—some have made themselves available “one in two” or …