ORIGINAL ARTICLES   

Panminerva Medica 1998 March;40(1):33-40

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Unilateral arterial reconstruction for aortoiliac occlusive disease

Yasuhara H., Shigematsu H., Muto T.

From the Department of Surgery I University of Tokyo, Hongo, Bunkyo-ku, Tokyo, Japan

Methods. The out­comes of 234 arte­ri­al bypass­es ­for aor­toi­liac occlu­sive dis­ease ­were ret­ro­spec­tive­ly ana­lyzed. Surgical pro­ce­dures includ­ed 60 bilat­er­al aor­to-/ili­of­e­mo­ral bypass­es, 140 uni­lat­er­al aor­to-/ili­of­e­mo­ral bypass­es, ­and 34 fem­o­rof­e­mo­ral ­cross-­over bypass­es. Ninteen ­patients (13.6%) ­showed dete­ri­ora­tion of ­the con­tra­lat­er­al ­iliac ­artery ­after ­the ­initial uni­lat­er­al oper­a­tion. Of ­these ­patients, 11 ­patients ­under-­went fur­ther sur­gi­cal treat­ments; includ­ing 5 uni­lat­er­al aor­tof­e­mo­ral bypass­es, 2 ­iliac throm­boen­dar­te­rec­to­mies, 2 ­iliac PTA’s, 1 fem­o­rof­e­mo­ral ­bypass, ­and 1 bilat­er­al aor­tof­e­mo­ral ­bypass. The remain­ing 8 ­patients ­received con­ser­va­tive treat­ment ­because of ­their ­risk fac­tors. The paten­cy ­rate of ­the uni­lat­er­al recon­struc­tion ­has ­improved dur­ing ­the ­last 12 ­years accord­ing to ­our his­tor­i­cal anal­y­sis.
Results. Our ­results dem­on­strate ­that uni­lat­er­al vas­cu­lar recon­struc­tion is a val­u­able alter­na­tive to con­ven­tion­al bilat­er­al recon­struc­tion in uni­lat­er­al symp­to­mat­ic aor­toi­liac occlu­sive dis­ease.
Conclusions. Accurate pre­op­er­a­tive diag­no­sis ­and ear­ly detec­tion of ­the pro­gres­sion of scle­rot­ic ­lesions on ­the con­tra­lat­er­al ­side ­are ­the ­keys to suc­cess­ful ­results.