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Unilateral arterial reconstruction for aortoiliac occlusive disease
H Yasuhara1, H Shigematsu, T Muto
1Department of Surgery I, University of Tokyo, Japan.
Methods:
The outcomes of 234 arterial bypasses for aortoiliac occlusive disease were retrospectively analyzed. Surgical procedures included 60 bilateral aorto-/iliofemoral bypasses, 140 unilateral aorto-/iliofemoral bypasses, and 34 femorofemoral cross-over bypasses. Nineteen patients (13.6%) showed deterioration of the contralateral iliac artery after the initial unilateral operation. Of these patients, 11 patients underwent further surgical treatments; including 5 unilateral aortofemoral operation bypasses, 2 iliac thromboendarterectomies, 2 iliac PTA's, 1 femorofemoral bypass, and 1 bilateral aortofemoral bypass. The remaining 8 patients received conservative treatment because of their risk factors. The patency rate of the unilateral reconstruction has improved during the last 12 years according to our historical analysis.
Results:
Our results demonstrate that unilateral vascular reconstruction is a valuable alternative to conventional bilateral reconstruction in unilateral symptomatic aortoiliac occlusive disease.
Conclusions:
Accurate preoperative diagnosis and early detection of the progression of sclerotic lesions on the contralateral side are the keys to successful results.