The First Aortic Endoaneurysmorrhaphy

Abstract

In 1888, Rudolph Matas described and performed a procedure (endoaneurysmorrhaphy) that revolutionized the treatment of aneurysms, which for centuries had been untreatable or simply involved treatment by ligation and other marginal techniques. In 1940, during the annual meeting of the American Surgical Association, Matas presented the excellent results he had obtained with 98 endoaneurysmorrhaphies, although none of these cases involved an aortic aneurysm. On November 4, 1904, a Spanish surgeon called Ricardo Lozano Monzón was the first person in the world to perform an endoaneurysmorrhaphy on a patient suffering from an abdominal aortic aneurysm. The case was reported in a local journal called La Clínica Moderna in 1905. Despite the journal’s limited circulation, Matas and others acknowledged that Lozano was the practitioner of the first, although admittedly unsuccessful, endoaneurysmorrhaphy on an abdominal aorta. Lozano’s attempt was followed by other equally unsuccessful ones until Isaac A. Bigger performed the first successful procedure in 1938. The different kinds of endoaneurysmorrhaphy that Matas used, which proved to be effective in the treatment of peripheral aneurysms, did not perform in the same way in aortic aneurysms. Nonetheless, the procedure paved the way for new ideas and contributions (Creech technique).