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Rivista di Medicina Interna

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,6

Periodicità: Trimestrale

ISSN 0031-0808

Online ISSN 1827-1898


Panminerva Medica 1998 Settembre;40(3):199-203


Advantages of ­straight ­graft for abdom­i­nal aor­tic aneu­rysm ­repair

Yasu­ha­ra H., Shig­e­mat­su H., Muto T.

From ­the Department of Surgery I University of Tokyo, Tokyo, Japan

The advan­tag­es of aneu­rysm ­repair ­with ­straight ­tube ­graft ­were stud­ied. Between January 1984 ­and March 1994, 277 ­patients ­with abdom­i­nal aor­tic aneu­rysm under­went oper­a­tion ­using ­straight or bifur­cat­ed pros­thet­ic ­grafts. Of ­those 277 ­patients, 37 ­patients (14%) ­received ­straight ­grafts ­and ­the remain­ing 240 ­patients ­received bifur­cat­ed ­ones. These ­two ­patient ­groups ­were com­pared in ­terms of influ­enc­es of intra­op­er­a­tive aor­tic clamp­ing, oper­a­tive ­time, post­op­er­a­tive recov­er­ing con­di­tion, inci­dence of per­i­op­er­a­tive com­pli­ca­tions, ­and ­long-­term ­results. Hemodynamic influ­enc­es of aor­tic clamp­ing ­were deter­mined by ­the chang­es in system­ic ­blood pres­sure. The dura­tion of aor­tic clamp­ing ­was sig­nif­i­cant­ly long­er in ­the bifur­cat­ed ­graft ­group ­than in ­the ­straight ­graft ­group (p<0.01). In addi­tion, ­the ele­va­tion of ­blood pres­sure ­was sig­nif­i­cant­ly high­er ­after aor­tic clamp­ing in ­the bifur­cat­ed ­graft ­group ­than in ­the ­straight ­graft ­group (p<0.05) ­although ­the ­blood pres­sure chang­es ­after ­release of ­the ­clamp ­did ­not dif­fer sig­nif­i­cant­ly. The bifur­cat­ed ­grafts ­required sig­nif­i­cant­ly long­er oper­at­ing ­time ­than ­the ­straight ­grafts. There ­was a ten­den­cy ­for ­the ­patients of bifur­cat­ed ­grafts to suf­fer ­from com­pli­ca­tions asso­ciat­ed ­with ­long dura­tion of ­the lap­a­rot­o­my, ­such as pneu­mo­nia ­and bow­el obstruc­tion. During an aver­age fol­low-up peri­od of 5 ­years, ­only ­one ­patient ­had to under­go sub­se­quent oper­a­tion ­for an aneu­rysm of ­the remain­ing ­iliac ­artery. This ­patient ­had ­had a dil­a­ta­tion of ­the hypo­gas­tric ­artery 1.5 ­times as ­large as is nor­mal in ­the ­first oper­a­tion. The ­long-­term ­results of ­the remain­ing 36 ­patients ­with ­straight ­graft ­was sat­is­fac­to­ry ­and ­the remain­ing ­iliac arter­ies ­were ­found to be ­intact. It is con­clud­ed ­that ­the sur­gi­cal ­repair ­with ­straight ­tube ­graft is a dur­able pro­ce­dure ­for ­patients ­with abdom­i­nal aor­tic aneu­rysms as ­long as ­the dil­a­ta­tion of ­the ­iliac ­artery is lim­it­ed to 1.5 ­times ­the nor­mal dil­a­ta­tion.

lingua: Inglese


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