[远端主动脉闭塞]。

Helvetica chirurgica acta Pub Date : 1994-07-01
M Genoni, L K von Segesser, A Laske, T Carrel, M Schönbeck, U Niederhäuser, P Vogt, M Turina
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引用次数: 0

摘要

1984年至1992年间,79例患者因肾下腹主动脉闭塞而接受手术治疗。12/79(15%)的患者因急性Leriche综合征接受了紧急手术。67/79(85%)的慢性闭塞患者选择选择性治疗。手术治疗包括57/79例(72%)的髂主动脉或股主动脉假体搭桥,11/79例(14%)的髂主动脉动脉内膜切除术,6/79例(8%)的栓塞切除术和5/79例(6%)的解剖外腋股动脉搭桥。对于慢性主动脉全闭塞,最常见的手术是解剖位置的人工旁路。急诊病例中有42%进行了栓塞切除术。早期发病率为26%(21/79)。最常见的并发症是血栓栓塞事件7例,心肌梗死4例,肾功能不全4例。30天死亡率2.5% (2/79);这两种情况的原因都是心肌梗塞。对于肾下腹主动脉动脉粥样硬化性闭塞疾病,人工旁路是首选的手术方法。对于栓塞性闭塞和高危患者,可采用其他负担较轻的治疗方法。
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[Occlusion of the distal aorta].

Between 1984 and 1992, 79 patients were operated for occlusion of the infrarenal abdominal aorta. 12/79 (15%) of the patients underwent emergency procedure for an acute Leriche syndrome. 67/79 (85%) of the patients with a chronic occlusion were treated electively. The surgical management includes in our series in 57/79 (72%) cases aortoiliac or aortofemoral prosthetic bypass, in 11/79 (14%) cases aortoiliac endarterectomy, in 6/79 (8%) cases embolectomy and in 5/79 (6%) extraanatomical axillofemoral bypass. For chronic total occlusion of the aorta the most common procedure was prosthetic bypass in anatomical position. For emergency cases embolectomy was performed in 42%. Early morbidity rate was 26% (21/79). The most frequent complications were thromboembolic events in 7 patients, myocardial infarction in 4 patients and renal insufficiency in 4 cases. The 30-day mortality 2.5% (2/79); the cause in both cases myocardial infarction. For atherosclerotic occlusive disease of the infrarenal abdominal aorta the prosthetic bypass is the first-choice surgical procedure. For embolic occlusions and for risk patients other less burdening procedures are available.

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