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June 23, 1989

The Vascular War

Author Affiliations

Meriter/Madison (Wis) General Hospital

Meriter/Madison (Wis) General Hospital

JAMA. 1989;261(24):3550-3551. doi:10.1001/jama.1989.03420240064020

To the Editor. —  Implicit in the commentary by Dr Zarins1 is the impression that vascular surgeons serve as a moderating influence, preventing aggressive and greedy radiologists and cardiologists from performing unindicated percutaneous angioplasty procedures. While in some instances this may occur, I feel that this generalization is unwarranted. Furthermore,in this characterization of vascular surgeons, Dr Zarins ignores the facts that probably the most aggressive marketing of "laser angioplasty" has been by some of his vascular surgical colleagues and that vascular surgeons represent one of the largest markets for the new, unproved laser devices. In many cases, the vascular surgeons are the ones performing percutaneous procedures, with little or no prior training in these techniques.Dr Zarins correctly characterizes the historical close cooperative and mutually beneficial relationship between radiologists and vascular surgeons, which generally serves the best interest of the patients. This assumes both types of physicians respect each