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Thoracoabdominal aortic aneurysms associated with celiac, superior mesenteric, and renal artery occlusive disease: methods and analysis of results in 271 patients.

Abstract：

:Two hundred seventy-one of 1509 patients who underwent thoracoabdominal aortic repairs had either celiac or superior mesenteric or renal artery occlusive disease. These latter patients were treated by endarterectomy or bypass between June 20, 1960 and Jan. 10, 1991. After 1987, the 30-day survival rate was 93% (79 of 85) compared with 90% (245 of 271) before 1988. Multivariate predictors of death were age, postoperative reoperation for bleeding, and cardiac complications (p less than 0.05). Renal complications (13% dialysis, 35 of 271) were associated with preoperative renal dysfunction, elevated preoperative serum creatinine level, urine clearance time of dye, extent of the aorta replaced, coagulopathy, and paraplegia or paraparesis (p less than 0.05). The incidence of postoperative renal dysfunction was reduced by renal artery endarterectomy (p less than 0.05). On univariate analysis the risk of renal failure was reduced by renal artery perfusion with cold Ringer's lactate solution (p less than 0.05). Gastrointestinal complications (9%, 25 of 271) were associated with a history of peptic ulcer disease on multivariate analysis (p less than 0.05). The Kaplan-Meier 5-year survival rates for patients with and without occlusive disease were 53% and 60%, respectively, and at 10 years 37% and 30%, respectively (p = 0.08). We conclude that endarterectomy or bypass of occlusive visceral disease reduces the risk of renal failure after thoracoabdominal aortic aneurysm repairs, does not decrease early or late survival, and does not increase the risk of gastrointestinal complications.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Svensson LG,Crawford ES,Hess KR,Coselli JS,Safi HJ

subject

Has Abstract

pub_date

1992-09-01 00:00:00

pages

378-89; discussion 389-90

issue

3

eissn

0741-5214

issn

1097-6809

pii

0741-5214(92)90371-E

journal_volume

16

pub_type

杂志文章

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