ABSTRACT
Endovascular repair of abdominal aortic aneurysm is now in an advanced stage of clinical investigation worldwide. From a historical perspective, the groundwork for placing vascular prostheses within the arterial lumen, as a minimally invasive approach, began with Charles Dotter in 1969, who demonstrated that coils could be successfully placed within the arteries of experimental animals with maintenance of patency.1 However, the concept of repairing an abdominal aortic aneurysm through the remote deployment of an endograft can be attributed to two investigators: Juan Parodi of Buenos Aires, Argentina, and Harrison Lazarus of Salt Lake City, Utah. These investigators, unknown to one another, began to develop experimental prototypes for tube graft deployment in the late 1970s. Parodi was the first to place a clinical endograft and reported this experience in 1991.2 His prosthesis utilized commercially available components including a lightweight fabric graft to which a Palmaz stent was sewn to the proximal end and balloon expanded for fixation below the renal arteries. Initially, the distal portion of the graft was allowed to selfexpand and did not have any means of fixation. Subsequently, a distal Palmaz stent was added to improve the distal seal of the endograft. Lazarus, working with industrial collaboration, in a company later to be called Endovascular Technologies (EVT), developed a catheter-based graft delivery system that was fabricated specifically for the purposes of endovascular repair of abdominal aortic aneurysm.3, 4 The first successful clinical implant took place at the University of California, Los Angeles (UCLA) Medical Center on 10 February, 1993, as a part of a phase 1, trial for clinical investigation approved by the Food and Drug Administration (FDA).5-9
Chuter et al. having studied the anatomic patterns of aortic aneurysm by computed tomography (CT) scanning, concluded that most aneurysms extended to the aortic bifurcation, and therefore a bifurcated prosthesis would have greater utility in managing a larger percentage of patients with aortic aneurysm.10, 11 He was the first to successfully develop a method for deploying a unit body aortic prosthesis.
