Aortoiliac Endarterectomy: a 9-year Experience

Abstract

Thirty-tw o pati ent s (medi an age: 51 years) und erwent a ortoilia c endartere ctomy betw een 1982 a nd 1990, for disa bling claudi cati on (27), rest pain (3). and tissu e loss (2). Th er e was no post-oper ativ e death a nd morbidity a ffected 6 pati ent s. Five pati ent s showed insuffi cient or suboptima l vas cularisa tion of a limb wh ich ju stified ea rly reoper ati on in four. Follow-up was obta ined in 31 pati ents with a med ia n time of 36 months (6 months to 8 yea rs). Five pati ents expe rience d recurren ce of claudicati on symptoms: tw o received a n ao rtofemoral bypass at 6 a nd 36 months. In th e other pati ents, dist al a rterial occlusive disea se acco unted for recurren ce a lone (2 pat ients) or in as sociation with ao rto iliac involvem ent (l). Techni cal pr oblem s or disputabl e indi cati ons wer e resp onsibl e for post operati ve failur e in 3 cases or ea rly recurr ence of sympto ms in 2. Cumulative pat ency rates of ao rtoiliac enda rte rectomy were 94 and 90 per cent at 2 a nd 5 yea rs , a nd actua rial rat es of clinical improvement wer e 90 a nd 82 per ce nt at 2 a nd 5 yea rs. resp ectively. Aort oilia c enda rte rec tomy pr ovides th e adva ntag es of avoiding foreign mat eri al. Th e success of th is reco nstruction dep ends on str ict crite ria of selectio n a nd surgica l expe rtise. It is indi cat ed for th e relati vely young pati en t with nonectasic disease wh er e atheroscl eros is ha s not att ac ked th e exte rn al iliac arter ies .

Aortoiliac endarterectomy as a viable alternative for revascularization in a woman with isolated aortoiliac disease and an anomalous right pelvic kidney

“… 6 , 7 , 8 In an 11-year retrospective cohort study of patients who had undergone AIE, Naylor et al 9 found 0% mortality at 30 days, with 92% patency at 5 years. Similarly, in a retrospective review of patients who had undergone AIE, Pretre et al 10 reported no postoperative deaths and 90% patency at 5 years. Durable results such as these can only be maintained if care is taken in selecting the ideal anatomic candidates.…”