[Surgical treatment of recurrent aortic-iliac-femoral occlusions]

At the department of vascular surgery of the Novgorod Regional Hospital 455 reconstructive operations for atherosclerotic occlusions in the aorto-ileo-femoral segment were performed in 1984-1991. Thrombotic reocclusion occurred in 58 patients (12.7%) for which a second operation had to be conducted, early thromboses of the reconstructed segment were encountered in 16 patients (3.5%) and late thromboses in 42 (9.2%). The work analyses the causes of early and late reocclusions, substantiates the surgical tactics, and discusses the technical characteristics of the operation. Thrombectomy with reconstruction of the distal anastomosis and the draining paths was the main method of treatment. It was conducted in 12 patients with early and in 21 patients with late reocclusions. The results of surgical treatment are shown. It is concluded that repeated reconstructive operations are a sufficiently effective measure for preserving the function of the earlier operated on limb; they made it possible to produce positive immediate results in 81.0% and late-term results in 64.3% of patients.