Vascular disease is accelerating at a pace that rivals other major chronic conditions, yet it remains under-recognized, under-diagnosed, and under-treated. By 2030, more than 100 million people will be at risk of developing significant vascular diseases. For too many, the first sign of trouble is not a warning – it’s a life-altering event: a stroke, limb loss, or aneurysm rupture.
It’s time to rethink our approach and move upstream toward prevention, earlier intervention, and long-term disease management.
Reframing the Vascular Care Continuum – from Emergency Response to Chronic Disease Management
Vascular care today is often reactive, triggered by urgent, high-stakes situations like ruptured aneurysms or critical limb ischemia. While these emergency interventions can be lifesaving, they rarely address the chronic nature of vascular disease. And long-term outcomes often hinge more on what happens before and after these procedures than the interventions themselves.
Consider peripheral arterial disease, for example. Patients may undergo procedures or take medication, yet they remain at risk. Without structured follow-up and risk mitigation, disease progression is likely—and many patients will suffer recurrent events.
Prevention must become our frontline strategy. Diabetes control, cholesterol management, smoking cessation, and patient education are essential, but remain underutilized. Too often, these measures are viewed as secondary rather than foundational.
To truly shift the paradigm, we need a collaborative, multidisciplinary care model. Vascular surgeons must work hand-in-hand with primary care providers, interventional cardiologists, and interventional radiologists. When care is continuous – not episodic – we can intervene earlier, monitor disease progression, and dramatically improve outcomes.
Innovation Is Accelerating, But Needs Strategic Guidance
At Mass General Brigham’s Heart and Vascular Institute, I see how cutting-edge research is reshaping what’s possible in vascular care, from dialysis access and limb-threatening ischemia to coagulation risk and complex aortic disease.
Technology is accelerating this evolution. Artificial intelligence (AI), in particular, is poised to transform how we diagnose and treat vascular conditions. AI has the potential to personalize treatment strategies, optimize surgical planning, and predict complications before they occur. But AI is only as effective as the data behind it. Incomplete or biased data can lead to flawed insights and misguided decisions.
Looking ahead, AI will help detect disease earlier through imaging analysis and recognition of clinical patterns that might otherwise be missed. But to move from promise to practice, these tools must be validated across diverse populations and implemented strategically at scale.
Attending the Society for Vascular Surgery’s Vascular Annual Meeting underscored just how rapidly this field is evolving. As a former President of the society, I had the honor of delivering a keynote address to more than 1,400 vascular specialists and allied health professionals – one of the largest audiences convened by SVS in recent years. In my remarks, I underscored a pivotal theme: our success depends on unity across disciplines and coordinated care throughout the patient journey. From breakthroughs in surgical techniques and device innovation to advances in AI-driven diagnostics, VAM reaffirmed that progress is fueled by a collaborative community committed to transforming vascular care for all.
Closing the Gaps in a Fragmented System
Despite this momentum, significant systemic barriers remain. Chief among them: a critical shortage of vascular specialists.
Even in densely populated academic centers, access to vascular care can be limited. In rural or underserved areas, many people live in “vascular deserts,” with little to no access to specialized care.
Addressing this shortage starts with building a stronger pipeline. Many medical schools still don’t include vascular disease in their core curriculum. As a result, many providers encounter these conditions only incidentally—if at all.
Meanwhile, demand for care is growing. Generation X is entering their 50s. Generation Z is starting to navigate adult health care. The need for timely, personalized vascular care will only increase. To meet it, we must make vascular health a visible, integral part of both primary and specialty care.
Meeting the Moment: A Call to Transform Vascular Care Before It’s Too Late
The question is no longer whether vascular disease is a looming public health challenge. It’s whether our current system is prepared to address it.
To improve outcomes and save lives, we must act on multiple fronts:
- Expand the vascular care workforce
- Make vascular surgeons a core part of every care team
- Invest in research and technology
- Integrate vascular care earlier in the patient journey
- And most importantly, shift from crisis response to proactive, patient-centered care
The need is urgent, but it’s not too late. If we act now, we can prevent countless medical emergencies and improve health outcomes for millions.
Matthew Eagleton, MD
Matthew Eagleton, MD, is an accomplished vascular surgeon who treats all aspects of peripheral vascular disease. He is an international expert on the treatment of complex aortic disease with endovascular therapy. He is the chief of the Division of Vascular and Endovascular Surgery and co-director of the Fireman Vascular Center at Massachusetts General Hospital, and leads a multidisciplinary team that manages vascular disease. In addition, he is co-director of the Mass General Thoracic Aortic Center.
