[Thrombendarterectomy in aorto-iliac occlusive disease]

An overview is given of the history and operative techniques of open and semiclosed thrombendarterectomy (TEA) for aortoiliac obstructive disease. The second part of the paper reviews the long-term results of 514 aortoiliac TEA's performed in 415 patients between 1959 and 1972. The data were prospectively acquired and the analysis was done on a retrospective basis. Median follow-up was over 15 years. Open and semiclosed TEA were performed on 167 and 347 limbs respectively. Hospital mortality was 1.2% and operative morbidity 11.1%. The overall life-table patency rate at 5, 10, 15, and 20 years was 93.4%, 90.4%, 84.2% and 69.5% respectively. Patency rate depended on significant factors: open versus semiclosed method (p < 0.04), anatomic localization: common iliac artery versus external iliac artery (p < 0.0004), preexisting stage of occlusive disease: stage II versus stage IV (p < 0.008), and gender: female versus male (p < 0.007). Patient's age was not a predictive factor on patency. The limb salvage rate was greater than 90% even in long-term follow-up. We conclude that in aortoiliac obstructive disease both open and semiclosed TEA give highly satisfactory long-term results with low mortality and morbidity rates.