The OBJECTIVE is to assess the patency of the inferior mesenteric artery and internal iliac arteries in the remote period after resection of the aneurysm of the infrarenal aortic segment. MATERIAL AND METHODS. The study included 33 patients who underwent resection of the abdominal aortic aneurysm with reconstruction of the inferior mesenteric artery and (or) internal iliac arteries from 1998 to 2017. All patients were examined with computed tomography scan with contrast to assess the patency of inferior mesenteric artery and internal iliac arteries. RESULTS. Patients were observed from 0.5 to 15 years. Among 30 patients with inferior mesenteric artery implanted into the prosthesis, 23 (76 %) patients had a passable inferior mesenteric artery and 7 patients had an occluded inferior mesenteric artery. The implanted inferior mesenteric artery maintained its patency for 3 years in 100% of cases, from 3 to 5 years – in 86%, after 5 years and more – in 62%. In one patient who underwent reconstruction of the internal iliac artery, thrombosis of the prosthetic-internal iliac shunt was found out in 1.5 years after the operation, without any clinical manifestations. One patient, underwent the reconstruction of the internal iliac artery, was diagnosed with thrombosis of the prosthetic-internal iliac shunt in 1.5 years after the operation, which was not accompanied by clinical manifestations. CONCLUSION. The high remote patency of the inferior mesenteric artery and internal iliac arteries reconstructed during resection of the aneurysm of the infrarenal aortic segment indicates the need for this procedure in order to prevent ischemic disorders of the digestive organs and pelvis.
The OBJECTIVE was to study the patency of the internal iliac artery and its effect to gluteus muscles blood supply and frequency of buttock claudication occurrence in the remote period after open infrarenal aortic aneurysm repair. MATERIAL AND METHODS. Examination of 37 patients after open infrarenal aortic aneurysm repair included collection of complaints, anamnesis, making CT scan with contrast and pelvic perfusion tomography. These methods allowed to assess the patency of the prosthesis and iliac arteries, calculate average blood flow rate in buttock muscles and frequency of buttock claudication occurrence depending on the lesion of the internal iliac arteries. RESULTS. Five-year patency of the internal iliac artery was 93 %. In case of passable internal iliac artery, the average blood flow rate in the ipsilateral buttock muscles was authentically higher than the same indicator in groups with stenotic or occlusive lesion of the internal iliac artery and its branches. In case of the disturbed internal iliac artery patency, the frequency of occurrence of the buttock claudication in the same side reached 50 %. CONCLUSION. High five-year internal iliac artery patency after open infrarenal aortic aneurysm repair attested the necessity of preservation the main blood flow in these arteries during the open infrarenal aortic aneurysm repair for the purpose of buttock claudication prevention. The CT scan allowed to evaluate the internal iliac artery patency and the average blood flow rate in the buttock muscles through perfusion tomography method which was necessary for differential diagnosis of the buttock claudication syndrome.
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