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Infrarenal aortic occlusion.

L W Traverso, J D Baker, E A Dainko

    Annals of Surgery
    |April 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Infrarenal aortic occlusion, characterized by leg pain and heavy tobacco use, can be successfully treated with aortic bypass surgery. This approach offers favorable long-term results for patients with this uncommon condition.

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    Area of Science:

    • Vascular Surgery
    • Cardiovascular Medicine
    • Interventional Radiology

    Background:

    • Infrarenal aortic occlusion is a rare condition presenting primarily with claudication.
    • Patients often exhibit heavy tobacco use but lack common comorbidities like myocardial infarction or diabetes.
    • Arteriography is crucial for diagnosis but presents technical challenges.

    Purpose of the Study:

    • To evaluate the outcomes of surgical interventions for infrarenal aortic occlusion.
    • To compare the effectiveness of aortic bypass grafts versus aorto-iliac endarterectomy.
    • To identify key factors for successful treatment of this uncommon vascular disease.

    Main Methods:

    • Retrospective review of 28 patients with infrarenal aortic occlusion treated over 11 years.

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  • Surgical interventions included aortic bypass grafts (18 patients) and aorto-iliac endarterectomy (8 patients).
  • Preoperative evaluation and intraoperative techniques were analyzed for their impact on outcomes.

    • Main Results:

    • Aortic bypass demonstrated favorable long-term results compared to endarterectomy, which had earlier symptom recurrence.
    • One early postoperative death occurred; renal insufficiency was noted in one case post-hypotension.
    • Despite thrombus extension to renal arteries in 77% of cases, renal artery occlusion was avoided with proper technique.

    Conclusions:

    • Infrarenal aortic occlusion, though challenging, is treatable with aortic bypass, yielding good long-term outcomes.
    • Careful preoperative assessment and meticulous intraoperative technique are paramount for successful treatment.
    • Aortic bypass is preferred over endarterectomy due to lower rates of symptom recurrence.