Problems related to previous thrombendarterectomy of the aorto-ilio-femoral arterial segment.
Early postoperative problems following aorto-ilio-femoral thrombendarterectomy include occlusion, bleeding and emboli. Technical details important for the prevention of these complications are discussed. Late problems include reobstruction, sexual dysfunction and aneurysm formation, the last complication being unusual following thrombendarterectomy. Late reobstruction is usually caused by progression of atherosclerosis and technical failures. Bypass grafting using synthetic material is usually the preferred method in redo aorto-ilio-femoral reconstruction since extensive dissection of the arteries is then avoided. We prefer a regular laparotomy for these operations. It might be an advantage to introduce ureteral stents making it easier to identify the ureter which may be surrounded by scar tissue following previous dissection. The creation of sufficient run-off is important. In several cases the procedure must therefore be supplemented with a profunda artery reconstruction. In case of localized and moderate obstruction PTA may be indicated for the relief of recurrent arterial obstruction following thrombendarterectomy.
D001012:Aorta, Abdominal / Q000601:surgery; D001018:Aortic Diseases / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D004617:Embolism / Q000601:surgery; D004691:Endarterectomy / Q000009:adverse effects*; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation