Surgical treatment of the thoraco-abdominal aneurysms.

Three thoraco-abdominal aneurysms treated surgically are presented. They were operated between July 1975 and February 1978. The different surgical-techniques are emphasized, which in turn allow us to comment on the complications that these types of patients may have. All our three patients were operated following the "Retrograde Revascularization Technique" proposed by Dubost. We think that the ischemic time of the visceral arteries is less than following the more simplified, less time consuming and perhaps less traumatic "Graft Inclusion and Direct Vessel Reattachment Crawford-Technique". The incidence of paraplegia can be reduced by maintaining normal blood pressure and reattaching intercostal and lumbar arteries to the graft. Two of our patients survived without presenting any complication in the last four years. The third died in the immediate postoperative period, due to insoluble coagulation problems after massive blood transfusion during surgery.