| Role of direct revascularization of the internal iliac artery during aortoiliac surgery. | |
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MedLine Citation:
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PMID: 9841685 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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R Hassen-Khodja; P Pittaluga; P Le Bas; S Declemy; M Batt |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of vascular surgery Volume: 12 ISSN: 0890-5096 ISO Abbreviation: Ann Vasc Surg Publication Date: 1998 Nov |
Date Detail:
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Created Date: 1998-12-22 Completed Date: 1998-12-22 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8703941 Medline TA: Ann Vasc Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 550-6 Citation Subset: IM |
Affiliation:
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Service de Chirurgie Vasculaire, Hôpital Saint Roch, Nice, France. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aortic Aneurysm, Abdominal / surgery* Aortic Diseases / surgery* Arterial Occlusive Diseases / surgery* Blood Vessel Prosthesis Implantation Colon / blood supply Female Humans Iliac Artery / surgery* Incidence Ischemia / epidemiology Male 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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