The Influence of Endovascular Techniques on Our Surgical Practice:A 10-Year View

Endovascular techniques have been used in our practice for more than 3 decades, although the increase in volume of procedures has accelerated during the last few years. The rationale for using these techniques is to lessen operative trauma to the patient by minimizing or eliminating the incision, reducing blood loss, and shortening or avoiding general anesthesia. These features in turn reduce or eliminate the need for postoperative intensive care and allow the patient to ambulate sooner, so that hospitalization is reduced. Very few randomized trials have compared endovascular with open vascular surgery, and there is no level-1 evidence to support most of the endovascular techniques. Nonetheless, the use of endovascular procedures to treat occlusive and aneurysmal diseases has produced results equal to those that can be achieved with open vascular surgery in certain vascular beds. Here, we will focus on some of these regions: aortoiliac stenosis/occlusion, femoral lesions, renal artery stenosis, visceral artery stenotic/occlusive lesions, carotid artery lesions, and aortic aneurysms.