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[Extra-peritoneal operations in arteriosclerotic lesions of the abdominal aorta and its branches]

R Z Losev, V A Gavrilov, M L Kliachkin

    Grudnaia I Serdechno-Sosudistaia Khirurgiia
    |October 1, 1991
    PubMed

    Insights

    The extraperitoneal approach for aorto-femoral reconstructions reduces complications. Postoperative plasmapheresis aids in managing hemorheological and lipoprotein disorders for better atherosclerosis obliterans treatment outcomes.

    Area of Science:

    • Vascular Surgery
    • Cardiovascular Medicine
    • Surgical Oncology

    Background:

    • Atherosclerotic lesions of the aorta, its branches, and limb arteries affect numerous patients.
    • Reconstructive surgery is a common treatment modality for advanced peripheral artery disease.

    Purpose of the Study:

    • To evaluate the outcomes of extraperitoneal versus transperitoneal approaches in aorto-femoral reconstructions.
    • To assess the efficacy of postoperative plasmapheresis in managing hemorheological and lipoprotein disorders following vascular surgery.
    • To determine the overall effectiveness of a comprehensive treatment strategy for atherosclerosis obliterans.

    Main Methods:

    • Analysis of surgical and clinical data from 692 patients undergoing treatment for atherosclerotic lesions.
    • Comparative assessment of extraperitoneal and transperitoneal approaches for aorto-femoral bypass.
    • Evaluation of postoperative plasmapheresis in 21 patients to normalize blood rheology and lipid profiles.

    Main Results:

    • The extraperitoneal approach demonstrated significant advantages over the transperitoneal approach, avoiding complications such as intestinal paresis, peritonitis, and intra-abdominal bleeding.
    • Coronary and cerebral vascular complications were not elevated with the extraperitoneal approach.
    • Postoperative plasmapheresis showed promise in normalizing hemorheological and lipoprotein disorders.
    • A complex treatment approach improved both immediate and long-term results of reconstructive vascular operations.

    Conclusions:

    • The extraperitoneal approach is a safer and more effective method for aorto-femoral reconstructions.
    • Postoperative plasmapheresis is a valuable adjunct in managing metabolic disturbances after vascular surgery.
    • A multidisciplinary approach enhances outcomes for patients with atherosclerosis obliterans.

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