[Abdominal aortic aneurysms associated with visceral artery stenoses].
During a 6-year period six patients had combined revascularizations for an abdominal aortic aneurysm and a high-grade (> 80%) stenosis of either the superior mesenteric artery (N = 14) and/or a renal artery (N = 60 including 6 bilateral revascularizations). Revascularizations of a visceral artery were done more often with a bypass graft (N = 61) than by endarterectomy (N = 6), reimplantation (N = 4) or endovascular technique (N = 3). Fifty patients had concomitant repair of the aorta and of the visceral artery, and ten had a staged repair, favored in-high risk patients and in cases of multiple visceral artery revascularizations. Four patients (7.5%) died (2 myocardial infarctions and 2 multisystem organ failure) and twelve (20%) had a non-fatal complication in the postoperative period. Survival was 91% at one year and 81% at 5 years. Our experience emphasizes the option of a staged approach in these high-risk patients, with the availability of extra-anatomic reconstruction, and the limited value of endovascular revascularization of the visceral arteries.
Cormier
F
F
Clinique de la Défense, Nanterre.
al Ayoubi
A
A
Fichelle
J M
JM
Cormier
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000150:complications* / Q000601:surgery; D004691:Endarterectomy; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D014656:Vascular Surgical Procedures / Q000401:mortality