[Current treatment strategies in acute distal aortic occlusion]

Forty-eight acute distal aortic occlusions were treated on an inpatient basis from January 1973 to December 1993. The mean age was 66 years. Twenty-seven patients had an acute thrombotic occlusion of the distal aorta, and a cardiogenic embolism was the cause of occlusion in 21 cases. The 43 operated patients evidenced a hospital mortality of 32.6% (14/43) and an amputation rate of 7% (3/43). Reperfusion was achieved in 20 patients solely by remote thromboembolectomy with the aid of a Fogarty catheter. A TEA and patch graft were performed in six patients; an extra-anatomic bypass was established in 9 cases and an aortobifemoral bypass in 8. Severe accompanying cardiac diseases were predominant in the patients with an embolic occlusion, whereas severe arteriosclerotic risk factors prevailed in all those with thrombotic occlusions. The mortality among our patients showed a statistically significant (p < 0.05) correlation only with the preoperative ischemia time.