Open repair for aortic occlusive disease: Indication, techniques, results, tips and tricks

Yamume Tshomba, G. Melissano, L. Apruzzi, D. Baccellieri, G. Negri, R. Chiesa

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim. The aim of this article was to review indications, techniques, and outcomes of a series of open repair for aortic occlusive disease. Methods. Between 1991 and 2013, 1071 patients (917 men, 154 women; mean age 62.6 years) underwent open repair for aortoiliac occlusive disease. According to TASC II classification, 123 patients (11.5%) had type B lesions, 343 (32%) type C, and 605 (56.5%) type D. Among type D lesions, 138 patients had Leriche's Syndrome with complete aortic occlusion. Nine hundred and eight aortobifemoral bypasses, 114 axillobifemoral bypasses, 42 aortic endarterectomies with patch aortoplasty, and 7 thoracobifemoral bypasses were performed. Associated endarterectomy of abdominal aorta was required in 191 patients (18.5%), of the femoral arteries in 297 (28.7%). Results. Perioperatively mortality was 0.6%; perioperative morbidity included cardiac (3.4% of patients), respiratory (2.6%), as well as acute renal insufficiency (2.6%). There were 26 (2.5%) cases of intraoperative distal embolization, 9 (0.8%) of acute graft thrombosis and 9 (0.8%) of bleeding requiring surgical revision within the first 24 hours after surgery. Sixty-one groin complications were reported in 57 patients (5.3%). During a mean follow-up time of 74 months (range 1-264), calculated actuarial occlusion-free survival at 12, 24, and 36 months was 94.8%, 91.8% and 87.2%, respectively. The limb-salvage rate in patients with critical limb ischemia was 87.3%. There were 11 (1%) graft infections. Conclusion. Open repair is a ductile strategy and may be tailored according to the patient clinical condition and disease anatomy. Long-term patency is excellent with low perioperative mortality and reasonable morbidity rates.
Original languageEnglish
Pages (from-to)57-68
Number of pages12
JournalJournal of Cardiovascular Surgery
Volume55
Publication statusPublished - 2014

Keywords

  • Aorta
  • Arterial occlusive disease
  • Cardiology and Cardiovascular Medicine
  • Open surgery
  • Surgery

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