Two Decades of Endovascular Abdominal Aortic Aneurysm Repair: Enormous Progress With Serious Lessons Learned

Abstract

The modern open surgical management of abdominal aortic aneurysm (AAA) has changed little since its inception in the 1950s. Endoaneurysmorrhaphy, first described by Rudolph Matas in 1888, involved ligating the branches of an aneurysm from within the aneurysm sac. Approximately 25 years later at the beginning of the 20th century, Alexis Carrel received the Nobel Prize for demonstrating the feasibility of suture repair of arteries and perfecting an anastomotic technique to join 2 vessels. With these techniques established, an AAA could be repaired by anastomosis of a synthetic conduit to the aorta just proximal and distal to the AAA, thereby preserving antegrade blood flow.1Dubost was the first to marry these 2 techniques in 1952, with the first report of a successful open AAA repair with homograft replacement.2 Aside from the development of various different types of conduit materials, open AAA repair has remained largely unchanged through to the present day.