Objective To understand trends of vascular interventions and changes in provision of vascular surgery.

Design A retrospective, descriptive, population-based study using hospital discharge data.

Setting Scotland 1991–2007.

Chief outcome measures Time trends in patient demographics and age and sex-specific population rates of these procedures.

Results In Scotland, between 1991 and 2007, a total of 153 117 vascular procedures of interest were performed. The proportion of men who underwent these procedures was higher than the proportion of women. The mean age of individuals who underwent amputation and lumbar sympathectomy decreased significantly over the period under review (p<0.001). In contrast, the mean age of individuals who underwent diagnostic endovascular procedures and therapeutic endovascular procedures increased significantly (p<0.001). However, the mean age of individuals who underwent open revascularisation remained fairly constant. For men aged <60 years, the age-specific rate of amputations increased significantly (p=0.003) from 21.1 to 61.1 per 100 000 over the study period (RR=1.33, 95% CI 1.09 to 1.61). Therapeutic endovascular procedure rates increased significantly (p<0.001) for men aged 60 to 74 years (RR=1.65; 95% CI 1.42 to 1.92) and 75 years or older (RR=2.6; 95% CI 1.96 to 3.47). Equally, a significant increase (p<0.001) in the population rates of therapeutic endovascular procedures for women of all age groups occurred over the period examined.

Conclusions A substantial change in the practice of vascular surgery has occurred in Scotland in the last 2 decades perhaps in response to new technologies and new clinical guidelines. This change should inspire further research to determine the outcomes of these vascular procedures