Minimally Invasive Vascular Surgery: Review of Current Modalities

Abstract

The concept of a minimally invasive approach to the treatment of vascular pathology was realized nearly 30 years ago when Charles Dotter described dilatation of atherosclerotic stenoses. Since that time biotechnology and therapeutic innovation have progressed to the point where entire medical subspecialties are based on the endoluminal treatment of diseases of the blood vessels. The most rapid progress has been made in the area of endoluminal treatment of vascular lesions, with angioplasty, stent, and stent graft deployment becoming an increasingly common method of treating various vascular lesions. Extraluminal endoscopic treatment of vascular disease has been gaining popularity, particularly for management of perforator vein incompetence associated with venous stasis disorders. Endoscopic saphenous vein harvest has become an accepted method for minimizing the length of incision required for saphenectomy. Vascular imaging has followed similar trends, with more detailed information being derived from tiny intravascular ultrasonic catheters. This article summarizes the current state of minimally invasive vascular surgery to provide the reader with an understanding of the efficacy of the various modalities. It also discusses future directions in the field.

An injectable shear-thinning biomaterial for endovascular embolization

“…Vascular injury causing uncontrolled bleeding is associated with mortality rates of more than 40% (1,2). Although the traditional open surgical approach has been the cornerstone in the treatment of these patients, there has been a recent shift in the use of minimally invasive endovascular embolization techniques, which can be safer and faster (3). From a pinpoint puncture of the common femoral artery, a combination of long wires and catheters is navigated through the vast arterial system under fluoroscopic guidance to reach the bleeding site for treatment.…”

“…2 Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. 3 Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA 02115, USA. 4 Department of Surgery, Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.…”

Minimally Invasive Revascularization Strategies for Chronic Lower Limb Ischemia

“…Procedural success is based on lesion morphology and location, with PTA treatments of nonocclusive, short-segment lesions in high-flow, proximal vessels demonstrating the greatest short-and long-term patencies. 7 Treated common iliac arteries maintain the highest patency rates after PTA. In the largest series, 1-and 5-year patency rates of 88.6% and 48.2%, respectively, have been reported.…”

Embolization of Vascular Malformations via In Situ Photocrosslinking of Mechanically Reinforced Alginate Microfibers using an Optical‐Fiber‐Integrated Microfluidic Device

“…This process involves inserting embolic materials into the aneurysm through a catheter to elicit ischemic necrosis by blocking blood supply. [ 3 ] However, current embolization procedures have several drawbacks. For instance, metal coils (e.g., platinum coils) used to fill aneurysms have the limitation of low filling rates caused by their high mechanical strength, which results in the remaining volume being occupied by coagulated blood.…”