Minimally invasive vascular surgery: Review of current modalities

The concept of a minimally invasive approach to the treatment of vascular p athology was realized nearly 30 years ago when Charles Dotter described dil atation of atherosclerotic stenoses. Since that time biotechnology and ther apeutic innovation have progressed to the point where entire medical subspe cialties are based on the endoluminal treatment of diseases of the blood ve ssels. The most rapid progress has been made in the area of endoluminal tre atment of vascular lesions, with angioplasty, stent, and stent graft deploy ment becoming an increasingly common method of treating various vascular le sions. Extraluminal endoscopic treatment of vascular disease has been gaini ng 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 require d for saphenectomy. Vascular imaging has followed similar trends, with more detailed information being derived from tiny intravascular ultrasonic cath eters. This article summarizes the current state of minimally invasive vasc ular surgery to provide the reader with an understanding of the efficacy of the various modalities. It also discusses future directions in the field.