Endovascular aortic repair: first twenty years

Area of Science:

• Vascular Surgery
• Medical Technology
• Interventional Radiology

Background:

• Endovascular aortic/aneurysm repair (EVAR) emerged in the early 1990s, significantly impacting clinical practice and patient care.
• The evolution of EVAR has involved contributions from clinicians, surgeons, interventional radiologists, and industry engineers.
• Comparative studies evaluating EVAR against traditional open surgical repair have been instrumental in its development.

Purpose of the Study:

• To review the contributions of clinicians and industry to EVAR's advancement over the past two decades.
• To highlight the development of hybrid vascular surgery as a new field.
• To analyze comparative studies on EVAR versus open repair and its application in other aortic diseases.

Main Methods:

• Review article analyzing the development of endovascular aortic repair (EVAR).
• Focus on contributions from physicians, surgeons, interventional radiologists, and industry representatives.
• Analysis of studies comparing EVAR with open surgical repair and other aortic disease treatments.

Main Results:

• EVAR has progressed rapidly, paralleling technological expansion over its first two decades.
• Randomized studies have identified EVAR-specific complications, guiding technological improvements and risk patient identification.
• Optimal outcomes are achieved in specialized vascular surgery centers equipped to handle complications.

Conclusions:

• EVAR's rapid development is a testament to collaborative efforts between clinicians and industry.
• Understanding EVAR complications through research is vital for refining the technique and patient selection.
• Specialized centers with comprehensive resources are essential for successful EVAR implementation and management.