[Development of vascular and endovascular surgery over the next 20 years].

Vascular surgery is a young surgical discipline which has experienced a stormy development driven by internal motivation and external constraints. Changes in the field are primarily a result of diverse external influences which are expected to continue into the future. The most significant intrinsic change has been the development of stent graft technology. External influences include extensive demographic changes, rapid progress in endovascular techniques to treat obstructive vascular disease, improved advanced training, state and non-state controls, certification requests without considering the feasibility of professional and structural implementation and changing public expectations. Progress in vascular medicine is stimulated by advances in imaging techniques and subsequent improved endovascular procedures. Nevertheless, external influences have, at least within the 'surgical' sphere of influence, led to formidable innovative efforts on the part of associations representing vascular surgeons. These innovative efforts are concentrated in the Academy of the German Society of Vascular Surgery and Medicine and will determine trends in coming years. The future will reflect their quality.