Document Detail


Ligation and extraanatomic arterial reconstruction for the treatment of aneurysms of the abdominal aorta.
MedLine Citation:
PMID:  7933265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Since Blaisdell et al. first described axillobifemoral bypass and aortic exclusion to treat patients at high risk with abdominal aortic aneurysms in 1965, this approach has been controversial. To help define the appropriate application of this procedure, the recent experience of the authors was reviewed.
METHODS: Twenty-six patients underwent operation between March 1980 and August 1992. Mean age was 71 +/- 7 years. Average aneurysm diameter was 7.0 +/- 1.5 cm. Sixty-nine percent of the aneurysms were symptomatic; 21% were suprarenal. All patients had serious comorbid factors. All underwent axillobifemoral bypass with iliac artery ligation; the infrarenal aorta was also ligated in 62%.
RESULTS: There were two postoperative deaths (7.7%). One- and two-year survival rates were 59% and 38%, respectively. Three patients died of aneurysm rupture (11.5%); the aorta had not been ligated in two of these patients. The remaining late deaths were due to comorbid conditions. Extraanatomic bypass grafts thrombosed in five patients; no limbs were lost.
CONCLUSIONS: Axillobifemoral bypass without aortic ligation does not effectively reduce the risk of aneurysm rupture. However, axillobifemoral bypass with aortic ligation is an acceptable treatment for patients with severe medical problems and symptomatic, anatomically complicated, or large abdominal aortic aneurysms. Because the risk of aneurysm rupture is not completely eliminated, this procedure should be reserved for patients with high-risk aneurysms who would not tolerate direct aortic replacement.
Authors:
W C Pevec; J W Holcroft; F W Blaisdell
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Publication Detail:
Type:  Clinical Trial; Journal Article; Review    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  20     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-15     Completed Date:  1994-11-15     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  629-36     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of California, Davis, Medical Center, Sacramento 95817.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / mortality,  surgery*
Axillary Artery / surgery*
Blood Vessel Prosthesis*
Comorbidity
Female
Femoral Artery / surgery*
Follow-Up Studies
Graft Occlusion, Vascular / mortality,  surgery
Humans
Iliac Artery / surgery*
Ligation
Male
Middle Aged
Polyethylene Terephthalates*
Postoperative Complications / mortality,  surgery
Reoperation
Risk Factors
Survival Rate
Time Factors
Chemical
Reg. No./Substance:
0/Polyethylene Terephthalates

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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