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[Acute aortic and iliac artery occlusion: a banality in vascular surgery?]
H W Menges1, W Schaupp, M Trede
1Chirurgische Klinik, Klinikum Mannheim der Universität, Heidelberg.
Insights
This study reviewed 70 cases of acute aortic or iliac artery occlusions, finding high amputation and mortality rates. Intraoperative angioplasty for thrombotic occlusions showed potential to reduce mortality in high-risk patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
Context:
- Analysis of 70 cases of acute aorta or bilateral iliac arteries occlusions operated between 1972 and 1986.
- Occlusions were attributed to embolization (41 cases) or thrombosis (29 cases).
- High-risk patient population (71%) with prolonged ischemia (44% > 6 hours).
Purpose:
- To evaluate outcomes of surgical interventions for acute aortic and iliac artery occlusions.
- To assess the impact of intraoperative angioplasty on mortality rates in thrombotic occlusions.
Summary:
- High amputation rate (22.8%) and mortality rate (42.8%) were observed.
- Patient cohort presented with extreme risk for surgery and anesthesia.
- Intraoperative angioplasty in 10 patients with thrombotic occlusions demonstrated potential for mortality reduction.
Impact:
- Highlights the significant risks associated with acute aortic and iliac occlusions.
- Suggests intraoperative angioplasty as a promising adjunctive therapy for thrombotic occlusions.
- Emphasizes the need for advanced interventional techniques in managing complex vascular emergencies.
Abstract:
From 1972 to 1986 70 acute occlusions of the aorta or bilateral iliac arteries were operated in our clinic. The occlusion was caused in 41 cases by embolisation, in 29 cases by thrombosis. Amputation rate was 22.8%, the mortality rate 42.8%. 71% of the patients were of extreme high risk regarding the operation as well as the anesthesia. In 44% of the patients the duration of complete ischemia was more than 6 h. Performance of intraoperative angioplasty (n = 10 patients) for dilatation of stenoses leading to thrombotic occlusions may lower the mortality rate.