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[Abdominal aortic aneurysms associated with visceral artery stenoses]
F Cormier1, A al Ayoubi, J M Fichelle
1Clinique de la Défense, Nanterre.
Journal Des Maladies Vasculaires
|January 23, 1999
Summary
Combined revascularizations for abdominal aortic aneurysms and visceral artery stenosis can be safely performed. A staged approach is recommended for high-risk patients, with bypass grafting being the preferred revascularization method.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Interventional Cardiology
Context:
- Abdominal aortic aneurysms (AAA) often coexist with visceral artery stenosis.
- High-grade stenosis (>80%) in superior mesenteric and/or renal arteries requires intervention.
- Combined AAA repair and visceral revascularization presents unique surgical challenges.
Purpose:
- To evaluate the outcomes of combined revascularizations for AAA and visceral artery stenosis.
- To compare different revascularization techniques for visceral arteries.
- To assess the safety and efficacy of staged versus concomitant repair strategies.
Summary:
- Over six years, 6 patients underwent combined AAA and visceral artery revascularization.
- Bypass grafting was the predominant technique for visceral revascularization (N=61).
- Staged repair was favored for high-risk patients and multiple visceral artery involvement, with 7.5% mortality and 20% morbidity.
- Five-year survival rates reached 81%.
Impact:
- The study highlights the feasibility and acceptable outcomes of combined AAA and visceral revascularization.
- A staged approach is emphasized for high-risk individuals, utilizing extra-anatomic reconstruction when necessary.
- Endovascular revascularization of visceral arteries demonstrated limited value in this cohort.