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[Late results following implantation of aortic bifurcation prosthesis]
M Jugenheimer1, C Michler, K Nagel
1Klinik und Poliklinik für Allgemein- und Abdominalchirurgie, Johannes-Gutenberg-Universität Mainz.
Insights
Aortic Y-prosthesis implantation improved outcomes for patients with chronic arterial occlusive disease, particularly those in higher stages. Long-term success depends on preoperative disease severity and extent.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
Context:
- Chronic arterial occlusive disease (CAOD) significantly impacts patient quality of life and survival.
- Aortic Y-prosthesis implantation is a surgical option for advanced CAOD.
Purpose:
- To evaluate the long-term efficacy and outcomes of aortic Y-prosthesis implantation in patients with CAOD.
- To identify factors influencing the success of this surgical intervention.
Summary:
- This retrospective study analyzed 181 patients with CAOD who received aortic Y-prostheses between 1976 and 1986.
- Patients in higher preoperative stages (Fontaine-Ratschow classification) showed greater benefit, with many achieving improved functional status.
- Optimal results were observed in unique aorto-iliac occlusions, and a 10-year survival rate of 59% was recorded, with most deaths attributed to comorbidities.
Impact:
- Aortic Y-prosthesis implantation offers significant benefits for selected CAOD patients, improving their clinical stage and quality of life.
- The procedure demonstrates a favorable long-term success rate with low lethality when considering preoperative disease characteristics.
- Findings underscore the importance of patient selection based on disease stage and extent for optimizing surgical outcomes in CAOD management.
Abstract:
From January 1976 to December 1986 181 patients with chronic arterial occlusive disease were provided with an Y-prosthesis of the aorta. In a retrospective study we reviewed the history of these patients. From 130 (72%) patients we obtained information about the further course of the disease, 83 (46%) patients were reexamined. Depending on the preoperative stage (Fontaine-Ratschow classification) of the chronic arterial occlusive disease, patients in higher stages had a greater benefit from the implantation by shifting into a more satisfactory stage. The majority of patients without any postoperative complaints (48%) belonged to the group, preoperatively classified into stage II B. Depending on the type of occlusion the best results were obtained in unique occlusions of the aorto-iliac vascular segment. 50% of the reexamined patients had no complaints although in 61% of these cases the superficial femoral artery was occluded in the mean time. 47 patients deceased during the interval of observation. In most cases death was caused by other manifestations of the basic disease (e.g. cardiac infarction or cerebral apoplexy). The 10-year-survival rate was 59%. The majority of patients with chronic occlusive disease of the pelvic arteries profited from the implantation of an aortal Y-prosthesis. The long-term success of this operation with its low lethality depends on the preoperative stage and the extent of the occlusive process.