Introduction

T his current supplement issue of Vascular marks the third annual issue. As with previous supplemental publications that focused on novel interventional techniques or endovascular devices, this edition features endovascular technologies that have not only influenced our approach in minimally invasive vascular interventions but also transformed our perspectives on vascular disease management.

Significant technological advances have taken place in the world of endovascular interventions in the past 3 years. We have gained greater understanding in using endovascular devices in the treatment of both occlusive and aneurysm disease. It has been 10 years since the Food and Drug Administration approved the first endovascular stent graft for abdominal aortic aneurysm (AAA) repair. Today this has become the most common treatment modality for patients with AAA. We have learned that complications such as endograft migration can occur, which can lead to endoleak and aneurysm reexpansion. Drs. Murphy and Arko discuss a novel endovascular stapling device that is designed to provide additional mechanical reinforcement so that the endograft can be securely anchored to the aortic neck to prevent endograft migration. Dr. W. Anthony Lee details a new endovascular technology with branched iliac endograft as a novel treatment strategy for patients with aortoiliac or hypogastric artery aneurysm.

The application of laparoscopic repair has transformed the treatment paradigm of abdominal pathologies as this technology is virtually applicable in the management or resection of every solid organ in the abdominal cavity. Many vascular surgeons have recently adopted this technology as another minimally invasive vascular intervention, in contrast to catheter-based treatment modality, in the management of both aortic occlusive and aneurysm disease. Drs. Cagiannos and Kolvenbach share their perspective on laparoscopic repair of complex aortic disease.

Lastly, this edition features two articles on percutaneous management of varicoceles and massive pulmonary embolism. The treatment outcomes of these percutaneous endovascular interventions were compared with those of other minimally invasive treatment modalities. As endovascular technologies continue to advance, more interventionalists will possess the knowledge base and technical skills to care for patients with ailments in nonvascular entities such as urologic or pulmonary disorders. This further underscores the significant implication of endovascular interventions, which provide therapeutic possibilities in a wide spectrum of diseases. A well-trained endovascular interventionalist, regardless of his or her specialty training, can use all available catheter-based technologies to provide comprehensive clinical care to both traditional vascular diseases and non-traditional vascular disorders. We hope you enjoy the information herein and welcome your feedback.