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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2000 March;7(1):53-64
language: English, Italian
Obstructive atherosclerotic disease of juxtarenal aorta. Case report and technical comments on surgical approach
Mavaro G., Martino A., Pumilia G., De Stefani S., La Barbera G.
From the Divisione di Chirurgia Vascolare (Primario Dott. A. Martino) Azienda Ospedaliera Civico Benfratelli, Palermo, Italy
Background. In approximately 5% of patients, obstructive atherosclerotic lesions of the abdominal aorta are localized at the juxtarenal level. Revascularization in these cases includes technical variants depending on the need for suprarenal clamping. The authors describe a case of juxtarenal aortic occlusion and provide a detailed description of the particular surgical technique used, comparing the results with those reported in studies emerging from a “Medline” search for the period 1989-1999.
Case report. A female 55-year-old patient suffering from bilateral gluteal claudication, who had undergone nephrectomy 25 years earlier for kidney donation, was hospitalized following the onset of resting pain over the past few months. Arteriography showed obstruction of the juxtarenal abdominal aorta and the iliac axes. The patient underwent aortobifemoral bypass following suprarenal aortic clamping.
Results. No anomalous renal function was observed postoperatively in spite of suprarenal aortic clamping with downstream ischemia lasting 15 minutes. Lymphorrhage aortic drainage from resolved spontaneously on day 14. The patient was dismissed on day 18.
Conclusions. If carried out in compliance with a number of surgical requirements, suprarenal aortic clamping allows obstructive lesions of the juxtarenal abdominal aorta to be treated with the minimum risk of renal ischemic lesions.