Ömer TETİK, Tevfik GÜNEŞ, Aykut ŞAHİN, Orhan GÖKALP, Berkan ÖZPAK, Ali GÜRBÜZ, Ufuk Yetkin, İsmail YÜREKLİ

Surgical management of chronic total occlusion of the abdominal aorta

Amaç: Bu çalışmada abdominal aortun kronik total oklüzyonu nedeniyle kliniğimizde ameliyat edilen hastalar retrospektif olarak incelendi. Çalışma planı: Bu çalışmaya Mart 2001 - Aralık 2009 tarihleri arasında abdominal aortun kronik total oklüzyonu nedeniyle kliniğimizde ameliyat edilen 20 ardışık erkek hasta (ort. yaş 61.8±8.0 yıl; dağılım 44-76 yıl) dahil edildi. Tüm hastalar elektif olarak ameliyat edildi. Dört hasta daha önceden koroner arter bypass greftleme ameliyatı geçirmişti. Abdominal aortun oklüzyonu tüm olgularda anjiyografi ile belgelendi. Altı hastada (%30) juxtarenal aort oklüzyonu, üç hastada (%15) suprarenal aort oklüzyonu ve 11 hastada (%55) infrarenal abdominal aort oklüzyonu tespit edildi. Tüm hastalarda abdominal aorta tromboendarterektomi ve aortobifemoral bypass yapıldı. Sol böbrek bir hastada (%5) safen ven grefti ile revaskülarize edildi. Bulgular: Tüm olgularda tam başarı elde edildi ve mortalite görülmedi. Ameliyat sırası veya sonrasında herhangi bir komplikasyon gelişmedi. Ortalama hastanede kalış süresi 7.1±1.4 (dağılım 5-11 gün), ortalama yoğun bakımda kalış süresi ise 2.4±0.6 (dağılım 1-3) gün idi. Yatış sırasında ne revizyon ne de tekrar girişim gerekli oldu. Sonuç: Deneyimlerimiz göz önüne alındığında aortik rekonstrüktif cerrahi, suprarenal, juxtarenal ya da infrarenal kronik total abdominal aort oklüzyonlarının tedavisinde uygulanabilecek başarılı bir seçenektir.

Kronik total abdominal aort oklüzyonunun cerrahi tedavisi

Background: In this study, we evaluated patients who underwent surgery for chronic total occlusion of the abdominal aorta in our clinic retrospectively. Methods: T wenty c onsecutive m ale p atients ( mean a ge 61.8±8.0 years; range 44 to 76 years) who underwent surgery in our clinic for chronic total occlusion of the abdominal aorta between March 2001 and December 2009 were included in this study. All patients were operated on electively. Four patients (20%) had undergone previous coronary artery bypass grafting surgery. The occlusion of the abdominal aorta was documented with angiography in all patients. Juxtarenal aorta occlusion occurred in six patients (30%), occlusion of the suprarenal aorta in three patients (15%), and occlusion of the infrarenal abdominal aorta in 11 patients (55%). An aortobifemoral bypass and abdominal aortic thromboendarterectomy were performed in all patients. The left kidney was revascularized with a saphenous vein graft in one patient (5%). Results: There was complete immediate success with no mortality. No complications occurred during or after the operation. The average duration of hospital stay was 7.1±1.4 (range 5 to 11 days) and an average intensive care unit stay was 2.4±0.6 (range 1 to 3) days. Neither revision nor reintervention was required during hospitalization. Conclusion: Considering our experience, aortic reconstructive surgery is a successful option for the management of chronic suprarenal, juxtarenal, and, infrarenal abdominal aortic occlusions.

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