Aorto-ilicofemoral arterial reconstructive surgery. With special reference to profunda revascularization.
A series of 177 patients undergoing 190 reconstructions for aorto-ilicofemoral arterial occlusive disease are reported. Operative procedures were carried out on a total of 294 limbs. On 87 of these, profunda revascularization was performed. The indication for surgery was advanced ischemia in 50% of the profunda revascularization patients and in 20.5% of the patients with superficial femoral arteries open or reconstructed. Dacron bypass graft was used in 99 reconstructions and ilicofemoral or femorofemoral vein graft in 8 cases. Endarterectomy was carried out in 83 cases. The overall operative mortality rate was 5.3%, renal failure being the most common cause of death. The 5-year survival rate was 73.5%. The rate of primary thrombosis was 2.6%. The 5-year cumulative patency rate of all aorto-ilicofemoral reconstructions was 91.3%. In the profunda revascularization group the corresponding percentage was 82.1%. There was no difference in the patency rate between reconstructions using Dacron graft or endarterectomy. The symptomatic results were good also in the profunda revascularization group, 93% of patients having relieved symptoms as an initial result of surgery. There were seven major amputations in 6 patients during the follow-up time and 5 patients needed further femoropopliteal reconstruction. It can be said that in most cases profunda revascularization is sufficient for satisfactory clinical results.
D000328:Adult; D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical; D001011:Aorta / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004691:Endarterectomy; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005268:Femoral Vein / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007084:Iliac Vein / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012737:Sex Factors; D013997:Time Factors; D014182:Transplantation, Autologous; D014680:Veins / Q000637:transplantation