[A comparative assessment of the results of end-to-end and end-to-side anastomoses in arterial reconstructions of the aorto-iliac segment].

The aim of this study to evaluate comparatively the early and long-term outcome of end-to-end (E-E) vs end-to-side (E-S) anastomoses in arterial reconstructions for aorto-iliac occlusive disease (AIOD). The early and late postoperative results of 150 arterial reconstructions for AIOD are evaluated, covering the period 1990 through 1993. All patients present AIOD II-IV clinical stage, randomized in three groups according to type of arterial reconstruction/anastomosis. Group A consists of 60 patients (pts) undergoing aortobifemoral/biprofunda bypass grafting (Ao-2F/P), with all proximal and distal anastomoses performed in the classical E-S fashion. Group B (40 pts)--Ao-2F/P replacement grafting (RG), with all proximal and distal anastomoses performed E-E, and simultaneous reconstruction of at least one hypogastric artery and/or inferior mesenteric artery (AMI). Group C (50 pts)--Ao2F/P or unilateral aorto-femoral/profunda bypass grafting (Ao-F/P) with EO-S proximal and E-E all distal anastomoses. The aforementioned groups are then compared to 30 pts (group O) free of vascular diseases. All patients are subjected to 18 months average follow-up study (range 6 to 32 months). The postoperative effect, including evaluation of the complete and regional hemodynamics by clinical and Doppler ultrasonography (DS) methods, is assayed. In some cases control angiography is performed as well. The complication rate--restenoses, rethromboses, false aneurysms and amputations--is estimated in percents. Statistically significant higher restenosis and rethrombosis rate is found in group A pts (56 per cent), compared to B (20 per cent) and C (25 per cent) which correlates with the early postoperative results, referred to in the authors' previous study.(ABSTRACT TRUNCATED AT 250 WORDS)