The first historical records about AAA are from Ancient Rome in the 2nd century AD, when Greek surgeon Antyllus tried to treat the AAA with proximal and distal ligature, central incision and removal of thrombotic material from the aneurysm. However, attempts to treat the AAA surgically were unsuccessful until 1923. In this year, Rudolph Matas performed the first successful aortic ligation on a human. Other methods that were successful in treating the 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).
Endovascular aneurysm repair was first performed in the late 1980s and has been widely adopted as a treatment option in the subsequent decades. In recent decades approximately 40,000 patients underwent aneurysm each year. In the United States, 15,000 deaths per year are attributed to abdominal aortic aneurysms. (8)
Anatomy: The aorta is the largest artery in the body. Arteries are vessels that carry blood away from the heart. Aorta arises from the left ventricle of the heart, forms an arch, and then extends down to the abdomen, where it branches off into two smaller arteries. Aorta is only 5 - 6cm. long and 16-20 mm. in diameter.
Is focal enlargement of the abdominal aorta usually involving the infra-renal portion of the vessel to more than 50% larger in diameter than the normal aorta or to greater than 3.0 cm in its largest true transverse dimension.
Aortic dissections occur when a tear forms in the intimal layer of the aorta creating a subintimal collection of blood (15). The pulsing high pressures in the aorta then force more blood into this space causing the hematoma to grow distally from its origin (7). The dissection commonly occupies approximately