Abstract
We report a review of 215 reconstructions for aorto-iliac arterial occlusive lesions, involving 156 patients. At 13 years, the cumulative patency rate of 158 aorto-femoral or aorto-iliac dacron synthetic bypass prostheses was 71.6 per cent as compared to 52.7 per cent at 5 years for 22 blunt endarterectomies and 47.4 per cent at 6 years for 35 axillo-femoral bypass prostheses. Of the 158 synthetic bypass prostheses, the cumulative patency rate at 13 years was 85.1 per cent in cases with no occlusive involvement of the peripheral arteries, significantly higher (p<0.03) than the 39.3 per cent patency rate at 7 years in cases in which associated femoro-politeal occlusive lesions were not treated. At 12 years, the patency rate was 53.2 per cent in cases in which associated femoro-popliteal occlusive lesions were treated during the same reconstructive intervention, i.e. markedly higher (p<0.08) than in patients in whom the degree of outflow in the distal vessels was poor. Our findings indicated that, in order to achieve a satisfactory long-term patency rate, it is important to treat associated occulusive lesions in the femoro-popliteal arteries.
Similar content being viewed by others
References
Crawford, E.S., DeBakey, M.E., Morris, G.C. Jr., and Garrett, E.: Evaluation of late failures after reconstructive operations for occlusive lesions of the aorta and iliac femoral and popliteal arteries,Surgery 47: 79–104, 1960.
Eugene, J.M., Goldstone, J., and Moore, W.S.: Fifteen years experience with subcutaneous bypass grafts for lower extremity ischemia,Ann. Surg. 186: 177–182, 1977.
Johnson, W.C., LoGerfo, F.W., Vollman, R.W., Corson, J.D., O’Hara, E.T., Mannick, J.A., and Nabseth, D.C.: Is axillo-bilateral femoral graft an effective substitute for aortic bilateral iliac femoral graft?Ann. Surg. 186: 123–129, 1977.
Kouchoukos, N.T., Levy, J.F., Balfour, J.F., and Butcher, H.R.: Operative therapy for aortoiliac arterial occlusive disease,Arch. Surg. 96: 623–633, 1968.
Lent, D.V., Kuijipers, P.J., Skotnicki, S.H., and Meyer, I.: Aorto-iliac surgery: A comparative study between thrombo-endarterectomy and bypass,J. Cardiovasc. Surg. 15: 352–355, 1974.
Malone, J.M., Moore, W.S., and Goldstone, J: The natural history of bilateral aortofemoral bypass grafts for ischemia of the lower extremities,Arch. Surg. 110: 1300–1306, 1975.
Morton, D.L., Ehrenfeld, W.K., and Wylie, E.J.: Significance of out-flow obstruction after femoropopliteal endarterectomy,Arch. Surg. 94: 592–599, 1966.
Summer, D.S. and Standness, D.E. Jr.: The hemodynamics of the femoro-femoral shunt,Surg. Gynecol. Obstet. 134: 629–633, 1972.
Vetto, R.M.: The femoro-femoral shunt, an appraisal,Am. J. Surg. 112: 262–265, 1966.
Vollmar, J., Trede, M., Chir, B., Laubach, K., and Forrest, H.: Principles of reconstructive procedure for chronic femoropopliteal occlusions: Report of 546 operations,Ann. Surg. 168: 215–223, 1968.
Waibel, P.P. and Dunant, J.H.: Late results of aorto-iliac reconstructive surgery,J. Cardiovasc. Surg. 14: 492–494, 1973.
Watt, J.K., Gillespie, G., Pollock, J.G. and Reid, W.: Arterial surgery in intermittent claudication,Br. Med. J. 1: 23–26, 1974.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kusaba, A., Inokuchi, K., Kamori, M. et al. Long-term results of reconstructive surgery for aorto-iliac arterial occlusive lesions. The Japanese Journal of Surgery 10, 238–244 (1980). https://doi.org/10.1007/BF02468754
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02468754