[Ligation by total or partial exclusion and extra-anatomic bypass: an alternative to subrenal aneurysmectomy]

The present study was designed in order to analyze our experience in surgical treatment of 18 patients with abdominal aortic aneurysm associate to a high surgical risk from 1982 (January-February) to 1988, both included. Selection criteria and surgical technical aspects were established. The patient age ranged from 60 to 82, with an average age of 75 +/- 7.5 years. The most frequently associated pathology was hypertension disease, followed by cerebrovascular disease and ischemic cardiopathy. Two patients died during surgical procedure. Fifteen patients, from the 16 surviving, suffered a complete thrombosis of their aneurysmatic sac one week after the induced thrombosis, by the ligature of afferent arteries of their aneurysm (iliac arteries). Only one patient suffered a second operation, 4 months after the initial procedure (partial exclusion) during which a total exclusion of aneurysm by infrarenal aortic ligature was performed. The successful operatory rate was of 14/15 (93.3%), with a mortality rate of 2/18 (11.1%). References are reviewed and our results commented.