The times they are a-changing’

Excerpt

Repair of problems associated to blood vessels has traditionally been a domain of surgeons. Resection of malfunctioning veins, restoring continuity of blocked or injured arteries and veins, or preventing lethal rupture of an aneurysm in the beginning of vascular repair was all done exclusively by open surgical means. Even endovascular surgery has been invented and—at least in the very beginning—been performed by surgeons as well and is as old as open surgery. Short-term survival has always been better for endovascular procedures, but they have failed to demonstrate long-term durability, even with repeat interventions. In the beginning of widespread use of vascular procedures, open surgery dominated the field. The main concern was durability. Patients with a short life expectancy deemed to be no candidates for surgery, because the procedures were lengthy and stressful to the patients, with a high morbidity and mortality. Good long-term results were necessary. …