The second half of the twentieth century saw vascu- agree or disagree, but will be stimulated to question lar surgery develop from a necessity for hemostasis their surgical management and explore possible - to a mature reconstructive art. However, this was ac- ternatives. companied by increasing patient expectations and The only certainty of the future is that it will bring the introduction of the alternative techniques of dila- change. An essential requirement for facing that tation and stenting. These factors have helped sur- change is multidisciplinary teamwork, and within geons to focus attention on the need for clinical audit that framework to define the roles of endovascular and to define clearly the limitations and standards of and invasive procedures, as well as the place of m- excellence that should be achieved in the specialty. ical management in the prevention and modification Vascular disease remains an extensive problem in of vascular disease.