The role of extraanatomic exclusion bypass in the treatment of disseminated atheroembolism syndrome.
We treated six patients with disseminated atheroembolism complicated by severe and unremitting pain from bilateral foot lesions. All patients had multiple and severe medical risk factors. One patient had a recent myocardial infarction, six patients had renal failure, and three were undergoing hemodialysis. Definitive aortic reconstruction was therefore precluded. After failing a course of medical therapy, each patient was treated with axillobifemoral bypass with exclusion-ligation of the external iliac arteries. Healing of foot wounds occurred in 11 of 12 limbs at risk, with one below-knee amputation required for progressive forefoot necrosis. In 12 patients with severe cardiopulmonary disease and limited life expectancy, exclusion-ligation bypass is an effective and safe palliative procedure for severe disseminated atheroembolism.
Department of Surgery, Albany Medical College, New York.
J L
JL
Kaufman
J
J
Saifi
B B
BB
Chang
D M
DM
Shah
R P
RP
Leather
D000368:Aged; D000792:Angiography; D001012:Aorta, Abdominal; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications* / Q000401:mortality; D001161:Arteriosclerosis / Q000150:complications* / Q000401:mortality; D001366:Axillary Artery / Q000601:surgery; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005263:Femoral Artery / Q000601:surgery; D005534:Foot Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010166:Palliative Care; D011379:Prognosis; D012307:Risk Factors