AS RECENTLY as thirty years ago the only surgical treatment for occlusive peripheral arterial disease was watchful expectancy until gangrene or infection of ischemic tissues developed; then high amputation of the extremity was performed without delay. Pioneer work on the surgical extirpation of aneurysms of the peripheral arteries and traumatic arteriovenous fistulas had been begun by Halsted and by Matas, but these operations were done with justifiable concern and considerable doubt as to the result. Aortic surgery was feared and avoided except for such crude procedures as insertion of wire into aneurysms.
During the past thirty years, and particularly since World War II, the surgical treatment of occlusive, degenerative, traumatic and congenital arterial disease has developed with increasing tempo and to an extraordinary degree. The early work of Leriche on periarterial stripping and the ramisectomy of Royal and Hunter led to the sympathetic ganglionectomy of Adson, which was found to