(Semi-)closed endarterectomy in occlusive aortoiliac disease.
BACKGROUND
Evaluation of the long-term results of a (semi-) closed endarterectomy of the aortoiliac segment with the use of the arterial disobliteration device.


METHODS
From 1984 until 2005, a total of 157 patients (mean age, 53 years) with aortoiliac occlusive disease underwent a (semi-)closed endarterectomy of the aortoiliac segment. The primary operation indication was disabling claudication in 60.5% and advanced symptoms of ischemia or gangrene in 39.5%. The (semi-) closed endarterectomy was performed in 75% through a standard left retroperitoneal approach.


RESULTS
Mean follow-up time was 18.2 years. Primary patency was 96% after 5 and 92% after 10 years. Fourteen patients underwent a reintervention within 30 days. The operative 30-day mortality rate was 1.5%. A reintervention for recurrence of occlusive disease during follow-up was necessary in 22 patients. At follow-up after an average of 18.2 years, 105 patients were alive, with 52 not related deaths.


CONCLUSIONS
Retroperitoneal (semi-) closed disobliteration, with the use of the arterial disobliteration device, of the aortoiliac segment for stenotic and occlusive vascular disease is a safe and successful procedure the results of which are comparable with the implantation of a vascular aortic prosthesis. We consider this technique a valuable tool in vascular surgery.
van Vugt
Raoul
R
Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. R.vanvugt@chir.umcn.nl
Kruse
Rombout R
RR
Sterkenburg
Steven M
SM
Fritschy
Wilbert M
WM
Moll
Frans L
FL
D001018:Aortic Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D003251:Constriction, Pathologic; D004691:Endarterectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007083:Iliac Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D018810:Magnetic Resonance Angiography; D008875:Middle Aged; D009426:Netherlands; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency