Abstract

Physicians may have first known what an aneurysm was as far back as the 14th Century BC in Egypt1, but by the early 19th century they were still trying to find satisfactory options for treating large or surgically inaccessible aneurysms.4,5 One of the techniques being considered was inserting a needle to provoke formation of a clot that would close off the aneurysm. The proof that this technique could work was discovered by C. H. Moore in 1864, during an autopsy of a gunshot victim. The bullet, lodged in the ascending aorta, was embedded in fibrin. Based on this, Moore speculated that a wire could be introduced into the body through a small wound, but then passed up to the aneurysm where it would coil and attract fibrin to block the aneurysm. Moore used 26 yards of coil to treat a thoracic aorta aneurysm; the patient died of sepsis, but the aneurysm had decreased in pulsation and size before that, and autopsy confirmed that the coils had promoted fibrin clotting as predicted. Later efforts trying a variety of materials, ranging from iron wire to gold-plated watch springs, also had poor outcomes. Attempts using electrical current to provoke clots during this period did not produce a consistent benefit either.5,6

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