Genoni M, von Segesser L K, Laske A, Carrel T, Schönbeck M, Niederhäuser U, Vogt P, Turina M
Klinik für Herz- und Gefässchirurgie, Universitätsspital Zürich.
Helv Chir Acta. 1994 Jul;60(5):723-8.
Between 1984 and 1992, 79 patients were operated for occlusion of the infrarenal abdominal aorta. 12/79 (15%) of the patients underwent emergency procedure for an acute Leriche syndrome. 67/79 (85%) of the patients with a chronic occlusion were treated electively. The surgical management includes in our series in 57/79 (72%) cases aortoiliac or aortofemoral prosthetic bypass, in 11/79 (14%) cases aortoiliac endarterectomy, in 6/79 (8%) cases embolectomy and in 5/79 (6%) extraanatomical axillofemoral bypass. For chronic total occlusion of the aorta the most common procedure was prosthetic bypass in anatomical position. For emergency cases embolectomy was performed in 42%. Early morbidity rate was 26% (21/79). The most frequent complications were thromboembolic events in 7 patients, myocardial infarction in 4 patients and renal insufficiency in 4 cases. The 30-day mortality 2.5% (2/79); the cause in both cases myocardial infarction. For atherosclerotic occlusive disease of the infrarenal abdominal aorta the prosthetic bypass is the first-choice surgical procedure. For embolic occlusions and for risk patients other less burdening procedures are available.
1984年至1992年间，79例患者接受了肾下腹主动脉闭塞手术。其中12/79（15%）的患者因急性勒里什综合征接受了急诊手术。67/79（85%）患有慢性闭塞的患者接受了择期治疗。在我们的系列研究中，手术治疗包括57/79（72%）例的主-髂或主-股人工血管旁路移植术、11/79（14%）例的主-髂动脉内膜切除术、6/79（8%）例的取栓术以及5/79（6%）例的解剖外腋-股旁路移植术。对于主动脉慢性完全闭塞，最常见的手术是解剖位置的人工血管旁路移植术。对于急诊病例，42%进行了取栓术。早期发病率为26%（21/79）。最常见的并发症是7例血栓栓塞事件、4例心肌梗死和4例肾功能不全。30天死亡率为2.5%（2/79）；两例均因心肌梗死。对于肾下腹主动脉粥样硬化闭塞性疾病，人工血管旁路移植术是首选的外科手术。对于栓塞性闭塞和高危患者，有其他负担较小的手术可供选择。
