Abstract
Stent-graft repair of aortic aneurysms has revolutionized treatment for this category of patients. Today, stent-grafts are considered standard care for most aneurysms. It is therefore highly inspiring and stimulating to read how Professor Volodos conceived the very first stent-grafts and subsequently used them in patients. Professor Volodos performed meticulous research, which culminated in the use of stent-graft technology for aneurysms throughout the entire aorta as early as 10 years before the rest of the world.
Professor Volodos refers to “fate” when he explains how he happened to be at the right place, at the right time, and with the right surroundings, which made it possible for him to formulate the concept of stent-grafting. This is typical of great pioneers. Obviously, there is a need for the prerequisite conditions to be in place for landmark advances to occur. However, the most likely explanation for “stumbling” upon new ideas and then subsequently developing them is a measure of Professor Volodos' genius. His ability to undertake laboratory-based research and translate this to the clinical setting is a reflection of his outstanding methodical and meticulous approach. This unique capability is the driving force behind many inventors.
Once the very first steps were taken, such as when the group discovered and improved the first zigzag stent, he instinctively knew this was the right way to go. It is quite striking that today the optimal diameter of the graft used for debranching from the ascending aorta to the supra-aortic vessels is 14 mm, the exact same diameter as the graft that Professor Volodos used in the very first debranching procedure ever done in the world.
It is not a coincidence that Professor Volodos' extensive experience with open cardiovascular surgery guided his development of a way to replace open surgery using endovascular techniques. It is also with great awe that we learn that even in the late 1980s his group was using a through-and-through wire for placing stent-grafts, split sheaths for facilitating the delivery of the grafts, and subsequently bifurcated devices for infrarenal aneurysm repair, including ruptured aneurysms. All of these techniques are routinely used today.
It is easy to forget the courage and patience it takes to break established norms and patterns of practice. Traditional thinking allows us to stay within our comfort zone without being questioned. The accomplishment of Professor Volodos in challenging the contemporary practice and his drive to promote and achieve his concept is exemplary.
The work of Professor Volodos should be an inspiration to all of us today and will continue to be so for future generations.