Abstract
Ligation of the human abdominal aorta has been made 19 or 20 times and always with fatal result.
Dubois, Assalini, Bujalsky, Pirigoff, Cooper, Keen and perhaps others attempted to occlude the abdominal aorta gradually by means of cleverly devised instruments which, carrying snares of silk, metal or catgut might be tightened or loosened at will. The instruments traversed the abdominal wall and hence infection was a complication common to all of the methods and defeated the plans of the operators.
In 1904 assisted by Dr. W. F. M. Sowers, I began a series of experiments on dogs in the hope of finding a safe method of occluding the aorta and curing aortic aneurysm. Bands of silver and aluminum curled about the aorta by an instrument constructed for this purpose were rolled tighter by the fingers until the desired degree of occlusion of this vessel was obtained. The abdominal wounds were closed with the expectation that they would have to be reopened one or more times for the purpose of progressively occluding the lumen of the artery. But in the course of our experiments we had opportunities to make trial in the human subject of partially occluding bands on other arteries (innominate, subclavian, carotid, femoral, popliteal) whose blood streams in some instances it seemed unsafe to cut off suddenly and completely, and found that incomplete occlusion of an artery sufficed to cure the aneurysm, possibly quite as surely as might have been expected of total occlusion. Hence, tentatively, I abandoned the idea of progressive closure of the aorta, determining, instead, to obliterate the lumen of this vessel, in the attempt to cure its aneurysm, to an extent which we had found quite safe in the dog.
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