EVOLUTION OF THE DIAGNOSIS AND TREATMENT OF ARTERIAL-DISEASE OVER THE COURSE OF TIME

The preoccupations of medicine vary during its history in relation to the socio-economic problems of the day and in relation to the diagnostic and therapeutic possibilities of the day. From a diagnostic standpoint, arterial claudication was described as early as 1830, i.e. almost a century before the standard classification of Leriche and Fontaine. Arterial investigations have been known for a great many years in terms of their principles (1662 for plethysmography, 1843 for Doppler effect). Their medical applications nevertheless date from only the past 20 years. Arterial imaging dates from the start of the century, but followed a very wide range of paths before reaching the technical advances of the present day. The oldest form of treatment is that of limb amputation. There has been extensive clinical and physiological discussion of hyperhemic techniques. In terms of arterial reconstruction, the debate has shifted from open access surgical reconstruction to percutaneous endoarterial reconstruction. However, the history of the diagnosis and treatment of arterial disease, although preoccupied by new and numerous techniques, has also involved the restructuring of patterns and ideas. The current attitude involves global management of all diseased arteries since the underlying problem is common and multifocal.