Endovascular aneurysm repair

In the past decade open surgical procedures have been partly replaced by the widespread introduction of laparoscopic and endoscopic techniques. Similar changes have affected vascular surgery, with the development of percutaneous transluminal angioplasty for peripheral atherosclerotic disease. Until recently, the treatment of abdominal aneurysms had relied solely on surgical exposure of the aneurysm and direct graft replacement. However, the recent advent of endovascular aortic aneurysm repair has offered an alternative to conventional surgical practice.1 This new technique has been enthusiastically endorsed by vascular surgeons worldwide,2 3 but, as yet, little proof has been offered to support its widespread introduction. Endovascular aneurysm repair involves the transfemoral or transiliac placement of a endograft within the aneurysm, with the aim of completely excluding the aneurysm sac from the circulation. The endograft is anchored in place by self expanding or balloon expandable stents, which may support all or part of the graft. The advantages of this technique …