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Active pharmaceutical ingredients may have unique properties when applied as nanoparticles or in nanostructured carrier systems due to the size and shape, as well as to the high surface to volume ratio. Therefore nanopharmaceuticals are surrounded by huge expectations on the part of nanomedicine and today nanotechnology is crucial for the development of pharmaceutical products. Nanopharmaceuticals have several benefits such as improved dissolution and bioavailability, targeted drug delivery, and they allow the introduction of nanotheranos tics. All these advantages offer an unprecedented opportunity for personalized therapy, aiding also the patient-centered formulation in order to ensure the efficacy and tolerability. Nanoparticle or nano-structured drugs offer unique advantages, but on the other hand the formulation could be a challenge which can be compared to their specific characteristics.

The large vertical midline or transverse transperitoneal approaches used to the conventional aortoiliac reconstruction are accompanied with a relatively high postoperative morbidity and mortality rate (2% to 5%) even in patients who are good risks undergoing aortic surgery. The purpose of this study was develop a new technique for aorto-bifemoral bypass operation to minimize the operative stress on these patients. The recommended left paramedian retroperitoneal approach using 5-6 cm skin-incision and a special retractor with three dimensional vision and using modified surgical instruments directly with eye control, offers the possibility to decrease the operative stress significantly and the sufficient control of the serious bleeding might occur. If it is necessary this exposure can be immediately converted to a conventional approach by simply enlargement of the incision. In our first case the functional results were very good and consequently hospitalization time and the convalescence period were short. This minimal access approach appears to diminish the catabolic response and is hopefully associated with accelerated recovery and virtual abolition of large wound-related complications. It could become the procedure of choice for selected patients with obstructive or aneurysmal aorto-iliac disease.