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Management of acute aortic occlusion

S B Drager, T S Riles, A M Imparato

    American Journal of Surgery
    |August 1, 1979
    PubMed

    Insights

    Acute aortic occlusion management in elderly patients often involves extraanatomic bypass. Axillobifemoral bypass proved effective, with no amputations required in this patient cohort.

    Area of Science:

    • Vascular Surgery
    • Cardiovascular Medicine

    Background:

    • Acute aortic occlusion typically affects elderly patients with severe cardiac conditions.
    • Extraanatomic bypass has become a key management strategy for these complex cases.

    Purpose of the Study:

    • To evaluate the outcomes of surgical management for acute aortic occlusion in elderly patients.
    • To assess the utility and risks of preoperative aortography in acute aortic occlusion.

    Main Methods:

    • Retrospective review of six patients (aged 55-87) with acute aortic occlusion.
    • Surgical interventions included axillobifemoral bypass and aortofemoral thrombectomy.
    • Analysis of perioperative complications, including renal failure and amputation rates.

    Main Results:

    • Four patients underwent successful axillobifemoral bypass, and one had an aortofemoral thrombectomy, with all survivors avoiding amputation.
    • One operative death occurred.
    • Two of three patients undergoing preoperative aortography experienced transient postoperative renal failure, suggesting limited diagnostic value and potential risk.

    Conclusions:

    • Axillobifemoral bypass is an effective treatment for acute aortic occlusion in elderly patients, offering limb salvage.
    • Preoperative aortography should be used judiciously due to the risk of renal complications and limited diagnostic benefit.

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