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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
A Journal on Vascular and Endovascular Surgery
Giornale Italiano di Chirurgia Vascolare 2001 December;8(4):265-73
language: English, Italian
Coexisting femoral, popliteal and aortic aneurysms. Surgical timing
Costa P., Marchetti T., Accrocca F., Gossetti B., Irace L., Benedetti-Valentini F.
From the 2nd Department of Vascular Surgery “La Sapienza” University of Rome, Rome
Background. Over the past few years aneurysms have been found more frequently in several arterial districts in the same patient owing to the extensive use of non-invasive diagnostic methods. The coexistence of aneurysms associated with the abdominal aorta and with peripheral vessels in the lower limbs sometimes raises problems of surgical timing.
Methods. From April 1992 to April 1999 27 patients were diagnosed with coexisting dilatation of the abdominal aorta (transverse diameter >3.5 cm) and a femoral aneurysm (FA) or popliteal aneurysm (PA). Thirteen patients underwent traditional surgery to correct both abdominal aortic aneurysm (AAA) and peripheral aneurysm. In 11 cases aortic treatment preceded treatment of the peripheral aneurysm, whereas in the remaining 2 cases PA was operated first due to rupture.
Results. The mean duration of follow-up was 35 months (4-82 months). Porioperative mortality was zero. No occlusions of aorto-aortic, aortoiliac or aorto-femoral bypasses were reported. No thromboses occurred in PA after AAA surgery. Overall patency at 3 years was 86%.
Conclusions. Surgical timing depends on the dimensions and characteristics of the aneurysmatic sac, the overall symptoms and the risk of complications. Except in emergency cases, priority must be given to AAA, although PA requires correction shortly after. In our experience, the first operation did not influence the results of the second.