[Surgical management of acute and chronic arterial occlusion]

Arterial occlusion may develop acutely and chronically, can affect any artery in the body. Surgical treatment of the disease is reasonable when definite symptoms occur. The forms of surgical treatment are: in acute arterial occlusion embolectomy or thrombectomy with Fogarty balloon catheter, under special circumstances in this group of patients we are compelled to use the typical surgical technique for chronic occlusion; the bypass and thrombendarteriectomy. Reconstructive operations are made most often on the lower extremities: thrombendarteriectomy or artificial prosthetic grafting on the aortoiliac section, autogenous saphenous vein bypass on the femoropopliteal section, and this is also the recommended procedure in the cases when the occlusive disease affects the crural arteries. Other operations in connection with occlusive arterial disease are lumbal and thoracal sympathectomy, fasciotomy and amputation at different levels. The recognition of occlusive disease on the extracranial carotid arteries are getting more and more common nowadays. The recommended operation in carotid occlusive disease is eversio endarteriectomy. Compared with the above the reconstructive operations of the mesenterial and renal arteries are rare. In the cases we do operate the operations are seldomly thrombendarteriectomies and more often bypasses with autogenous saphenous vein or artificial prosthetic grafts.