Emergency aorto-iliac aneurysm surgery with low mortality and morbidity

The authors present a consecutive series of 27 patients (26 men, one woman), urgently operated for aortic or iliac aneurysm during the period 1986-1994. Mean age was 68 years. Free rupture was found in 16 cases, 8 times a rupture with important retroperitoneal haematoma and fissurisation in 4. There were three ruptures of iliac aneurysms. In two cases arterio-venous fistulisation occurred: one ilio-iliac, another aorto-caval. For two juxta-renal aneurysms, supra-renal crossclamping was necessary and nephroplegia was used. Every reconstruction was done by Dacron prosthesis: a straight tube (47%), an aortobi-iliac (15%) or an aorto-bifemoral bifurcation prosthesis (38%). Mortality was 19% (0.0654 to 0.315, 90% confidence limits) with one intra-operative death. The morbidity was 49%, mostly by respiratory and/or renal complications, and mainly transient in nature.