ORIGINAL ARTICLES  VASCULAR PAPERS 

The Journal of Cardiovascular Surgery 1998 April;39(2):141-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Abdominal aortic aneurysm and lower-limb occlusive arterial disease

Hassen-Khodja R., Le Bas P., Pittaluga P., Batt M., Declemy S., Bariseel H.

From the Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Saint-Roch, Nice, France

Back­ground. Abdom­inal ­aortic aneu­rysms (AAA) are asso­ciated ­with ­lower-­limb occlu­sive arte­rial dis­ease (LLOAD) in 20-40% of ­patients. Ret­ro­spec­tive anal­ysis of 200 elec­tive AAA ­repairs and com­par­ison ­with lit­er­a­ture ­data ­revealed ­that ­LLOAD has ­little influ­ence on stan­dard ther­a­peutic man­age­ment of AAA.
­Methods. In ­this ­study, ­only 2.5% of the ­patients ­required femor­o­pop­li­teal ­bypass ­along ­with aneu­rysm ­repair. In con­trast, aneu­rysm ­repair was asso­ciated ­with ­lumbar sym­pa­thec­tomy in 30% of ­cases ­owing to exis­tence of periph­eral arte­rial dis­ease.
­Results. Con­cur­rent ­LLOAD did not sig­nif­i­cantly ­increase the oper­a­tive mor­tality of AAA, but post­op­er­a­tive periph­eral arte­rial com­pli­ca­tions ­were ­more fre­quent in ­patients ­with ­both aneu­rysmal and occlu­sive dis­ease.
Con­clu­sions. ­Although con­com­i­tant ­LLOAD did not ­adversely ­affect the ­long-­term sur­vival of ­patients who under­went sur­gical ­repair of AAA, ­this sub­group of ­patients was at ­higher ­risk of aggra­va­tion of ­their ­lower ­extremity arte­rial ­lesions.