[Role of preventive surgery in patients with multiple arterial disease. 700 patients successively treated by revascularization operations].
In a series of 700 patients who underwent successive recanalizations, 1.8% of patients who had coronary bypass and 8.1% of those operated upon for arteritis presented with associated lesions of the carotid arteries; 10% of patients with arteritis and 25.7% of patients with carotid artery lesions had a history of coronary artery disease. Although associated arterial lesions were relatively frequent, no coronary bypass was carried out preventively. Seven patients had preventive endarteriectomy of the carotid artery (6 before surgery for arteritis and 1 concomitantly with coronary bypass) without complications ascribable to angiography or surgery. Post-operative or medium-term complications of coronary artery and carotid artery lesions were exceptional. Except for one questionable case, the patients' general condition was so poor that they could not have benefited from preventive surgery. No post-operative complications due to associated lesions of the renal or gastrointestinal arteries occurred in this series. Only one patient had bilateral recanalization of the renal arteries during surgical treatment of the aortic bifurcation. In view of these findings, systematic exploration by invasive methods of asymptomatic or clinically stable associated arterial lesions seems to be unnecessary. This view is shared by most authors. The best way of preventing complications from associated arterial lesions resides in the quality and improvement of modern intensive care techniques.
D000787:Angina Pectoris / Q000150:complications / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000601:surgery*; D001167:Arteritis / Q000150:complications* / Q000601:surgery; D002340:Carotid Artery Diseases / Q000150:complications / Q000601:surgery; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000150:complications; D004064:Digestive System / Q000098:blood supply; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control; D012078:Renal Artery Obstruction / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies
Place des interventions préventives chez le polyartériel. Septcents malades traités de façon consécutive par une intervention de revascularisation.