Abdominal aortic aneurysm historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D.

Overview

The etymology of the word aneurysm comes from the Greek word for "dilatation". Abdominal aortic aneurysm as a medical condition has been recognized since ancient times, but was not been successfully treated until the early part of the 20th century. In 1923, Rudolph Matas (who also proposed the concept of endoaneurysmorrhaphy), performed the first successful aortic ligation on a human. In 1949, Albert Einstein was operated on by Rudolf Nissen by wrapping the aorta with polyethene cellophane, which induced fibrosis and restricted the growth of the aneurysm. In 1951, Charles Dubost performed the first AAA repair using a homograft. In 1953, Blakemore and Voorhees repaired a ruptured AAA using a Vinyon-N graft (nylon). In 1962, Javid and Creech reported the technique of endoaneurysmorrhaphy. In 1980, Parodi et al described an endovascular repair.

Historical Perspective

2nd Century AD

The first historical accounts regarding abdominal aortic aneurysm date from Ancient Rome, more precisely from the 2nd century AD, when Greek surgeon Antyllus tried to treat an abdominal aortic aneurysm with proximal and distal ligature, along with central incision and evacuation of thrombotic material from the aneurysm.

1923

However, attempts to treat the AAA surgically were unsuccessful until 1923. In that year, Rudolph Matas (who also proposed the concept of endoaneurysmorrhaphy), performed the first successful aortic ligation on a human.[1]

1949

Other methods that were successful in treating an AAA included wrapping the aorta with polyethene cellophane, which induced fibrosis and restricted the growth of the aneurysm. Albert Einstein was operated on by Rudolf Nissen with use of this technique in 1949, and survived five years after the operation.[2]

1951

Charles Dubost performed the first AAA repair using a homograft.

1953

Blakemore and Voorhees repaired a ruptured AAA using a Vinyon-N graft (nylon). Later, they were replaced by Dacron and polytetrafluoroethylene (PTFE). Silk sutures were banned because of degeneration, in favor of braided Dacron, polyethylene, and PTFE sutures, all of which retain tensile strength.

1962

Javid and Creech reported the technique of endoaneurysmorrhaphy, which dramatically reduced mortality.

1980

Parodi et al described an endovascular repair using a large Palmaz stent and unilateral aortofemoral and femorofemoral crossover Dacron grafts.[3]

References

  1. Livesay JJ et al. Milestones in Treatment of Aortic Aneurysm. Tex Heart Inst J 2005; 32: 130–134. PMCID 1163455
  2. Famous Patients, Famous Operations, 2002 - Part 3: The Case of the Scientist with a Pulsating Mass from Medscape Surgery
  3. Parodi JC, Palmaz JC, Barone HD (1991). "Transfemoral intraluminal graft implantation for abdominal aortic aneurysms.". Ann Vasc Surg. 5 (6): 491–9. PMID 1837729. 

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