Juxtarenal aortic occlusion.
The authors' experience with 113 aortic occlusions in 103 patients during a 26-year period (1965 to 1991) is reviewed. The authors found three distinct patterns of presentation: group I (n = 26) presented with acute aortic occlusion, group II (n = 66) presented with chronic aortic occlusion, and group III (n = 21) presented with complete occlusion of an aortic graft. Perioperative mortality rates were 31%, 9%, and 4.7% for each respective group and achieved statistical significance when comparing group I with group II (p = 0.009) and group I with group III (p = 0.015). Group I presented with profound metabolic insults due to acute ischemia and fared poorly. Group II presented with chronic claudication and did well long-term. Group III presented with acute ischemia but did well because of established collateral circulation. The treatment and expected outcome of aortic occlusion depends on the cause.
Tapper
S S
SS
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Jenkins
J M
JM
Edwards
W H
WH
Mulherin
J L
JL
Martin
R S
RS
Edwards
W H
WH
D000206:Actuarial Analysis; D000208:Acute Disease; D001012:Aorta, Abdominal; D001014:Aortic Aneurysm / Q000401:mortality / Q000601:surgery*; D001018:Aortic Diseases / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000401:mortality / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006083:Graft Occlusion, Vascular / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome