We read with great interest Prendes et al.’ s commentary
1
on lower limb revascularisation in low and middle income countries (LMICs). It has become increasingly apparent that the burden of vascular diseases disproportionally affects vulnerable and LMIC populations as a result of the epidemiological transition away from infectious diseases and towards non-communicable diseases, as a result of the rise in smoking, air pollution, obesity, diabetes, and trauma.2
Access to emergency and essential vascular surgical care, however, is grossly lacking in LMICs.3
The resource constraints in rural or LMIC centres and local variation in vascular disease burden requires context appropriate guidelines informed by local practices, pathophysiology, and care accessibility. Efforts have been made to propose comprehensive guidelines for essential vascular care in LMICs
2
; however, the paucity of data majorly impedes further advancement of comprehensive vascular care in LMICs, especially for non-traumatic vascular disease.The lack of data is, at least in part, driven by limited attention by the academic vascular community.
4
A recognition of the global surgical momentum by the vascular community will be essential to catalyse sustainable change, informed by data driven evidence, bilateral academic partnerships, and equitable practices. Now is the time to move towards the global vascular surgical tipping point to ensure that no patient is left behind.References
- Outcomes of lower limb revascularisation in low and middle income countries.Eur J Vasc Endovasc Surg. 2020; 60: 567
- Consensus recommendations for essential vascular care in low- and middle-income countries.J Vasc Surg. 2016; 64 (e1): 1770-1779
- Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development.Lancet. 2015; 386: 569-624
- Placing equity at the core of vascular Surgery research.J Vasc Surg. 2020; ([In Press])
Article info
Publication history
Published online: August 19, 2020
Accepted:
August 4,
2020
Received:
July 27,
2020
Identification
Copyright
© 2020 European Society for Vascular Surgery. Published by Elsevier B.V.
User license
Elsevier user license | How you can reuse 
Elsevier's open access license policy
Elsevier user license
Permitted
For non-commercial purposes:
- Read, print & download
- Text & data mine
- Translate the article
Not Permitted
- Reuse portions or extracts from the article in other works
- Redistribute or republish the final article
- Sell or re-use for commercial purposes
Elsevier's open access license policy
ScienceDirect
Access this article on ScienceDirectLinked Article
- Outcomes of Lower Limb Revascularisation in Low and Middle Income CountriesEuropean Journal of Vascular and Endovascular SurgeryVol. 60Issue 4
- PreviewWijeyaratne et al. report outcomes of 367 patients undergoing lower extremity bypass for chronic limb threatening ischaemia (CLTI) in a university hospital in Sri Lanka.1 More than 202 million people are currently affected by peripheral arterial disease (PAD) worldwide.2 A 23.5% global increase was observed between 2000 and 2010, with a strikingly higher relative increase of PAD death rates and disability adjusted life years in low and middle income countries (LMICs) vs. high income countries.3
- Full-Text
- Preview
Related Articles
Comments
Commenting Guidelines
To submit a comment for a journal article, please use the space above and note the following:
- We will review submitted comments as soon as possible, striving for within two business days.
- This forum is intended for constructive dialogue. Comments that are commercial or promotional in nature, pertain to specific medical cases, are not relevant to the article for which they have been submitted, or are otherwise inappropriate will not be posted.
- We require that commenters identify themselves with names and affiliations.
- Comments must be in compliance with our Terms & Conditions.
- Comments are not peer-reviewed.
