Renal failure complicating aortoiliofemoral reconstructive procedure

Fifteen of 20 patients who developed acute renal failure following aortoiliac reconstructive procedures did not survive. Predisposing factors uncovered in this retrospective review include advanced age, associated atherosclerosis in other organ systems, and abnormalities of preoperative renal status. Operative time was shorter and blood transfusion was less in the survivor group. Alerted to the contributing factors and lethan effects of this complication, selection of surgical procedures in these patients might be modified. An extra-anatomic bypass or even amputation may be a safer alternative to reconstructive procedures in certain patients with a high risk of postoperative renal failure.