Classical and endovascular surgery: indications and outcomes

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Medicine

Background:

• Traditional surgical revascularization (endarterectomy, bypass grafting) has been the standard for over 40 years for atherosclerotic peripheral vascular disease.
• Limitations of open surgery include general anesthesia, lengthy incisions, prolonged hospitalization, and higher morbidity/mortality rates.

Purpose of the Study:

• To highlight the evolution of vascular interventions from open surgery to advanced endovascular techniques.
• To emphasize the expanding role and advantages of percutaneous therapies in treating a wide range of vascular pathologies.

Main Methods:

• Overview of established endovascular techniques: thrombolysis, laser angioplasty, atherectomy, balloon angioplasty, and intravascular stenting.
• Introduction of endoluminal grafting for aneurysmal and long-segment occlusive diseases.
• Integration of catheter-based interventions with traditional surgical training for vascular surgeons.

Main Results:

• Endovascular approaches allow intraluminal treatment for stenoses and occlusions across nearly all circulatory systems.
• Percutaneous therapies offer significant advantages: no general anesthesia, shorter incisions, reduced hospital stays, and lower complication rates.
• Endoluminal grafting expands endovascular treatment options to include aneurysms and complex occlusive disease.

Conclusions:

• Endovascular techniques represent a major advancement in the vascular surgeon's toolkit.
• These minimally invasive procedures are poised to become the preferred treatment for most vascular conditions.
• The future of vascular intervention lies in the combined application of surgical expertise and endovascular technology.