Document Detail

Role of direct revascularization of the internal iliac artery during aortoiliac surgery.
MedLine Citation:
PMID:  9841685     Owner:  NLM     Status:  MEDLINE    
The purpose of this retrospective study was to determine the indications and efficacy of direct revascularization of the internal iliac arteries during aortoiliac reconstruction in the prevention of postoperative colonic and pelvic ischemia. This study included 540 patients who underwent aortoiliac reconstruction between January 1987 and December 1996 for nonruptured abdominal aortic aneurysm in 341 cases (63%) and occlusive aortoiliac disease in 199 cases (37%). Mean age was 67.4 years. A tubular aortic prosthetic graft was used in 36 patients and a bifurcated prosthetic graft in the remaining 504 patients. Direct revascularization of the internal iliac artery was performed 102 times in 85 patients (72 with aortic aneurysms and 13 with occlusive aortoiliac disease). The indication for direct revascularization was absence of adequate retrograde flow in 54 cases (53%), absence of anterograde flow in 19 cases (19%), and aneurysmal involvement of the origin of one internal iliac artery in 29 cases (28%). Concomitant revascularization of the inferior mesenteric artery was performed in 14 cases (2.5%). Twenty-two patients (4.1%) died during the immediate postoperative period and two (0.4%) presented nonfatal colonic ischemia. Fatal pelvic ischemia occurred in one patient following treatment of an aortoiliac aneurysm with retrograde revascularization of the internal iliac artery. Postoperative rest pain due to buttock ischemia was observed in three patients (0.6%) in whom direct revascularization of the internal iliac artery was not performed. In the subgroup of patients who underwent direct revascularization of the internal iliac artery, there were 3 deaths (3.5%), 13 nonfatal complications (15.3%), and no colonic ischemia. In this series direct revascularization of the internal iliac artery was performed in a high proportion of cases (15.7%) and did not increase the postoperative morbidity/mortality rate. The incidence of postoperative colonic and pelvic ischemia was low (0.6%). Direct revascularization of the internal iliac artery in selected patients appears to be effective in the prevention of postoperative pelvic and colonic ischemia.
R Hassen-Khodja; P Pittaluga; P Le Bas; S Declemy; M Batt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of vascular surgery     Volume:  12     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-22     Completed Date:  1998-12-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  550-6     Citation Subset:  IM    
Service de Chirurgie Vasculaire, Hôpital Saint Roch, Nice, France.
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MeSH Terms
Aortic Aneurysm, Abdominal / surgery*
Aortic Diseases / surgery*
Arterial Occlusive Diseases / surgery*
Blood Vessel Prosthesis Implantation
Colon / blood supply
Iliac Artery / surgery*
Ischemia / epidemiology
Mesenteric Artery, Inferior / surgery
Pelvis / blood supply
Postoperative Complications / epidemiology
Retrospective Studies

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

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