Abstract:Objective:To study the rational surgical approaches for patients with juxtarenal abdominal aortic occlusion, with or without combined vascular regions of the body.
Methods:Clinical data of 17 patients with juxtarenal abdominal aortic occlusion admitted to our department form 2004—2008 were analyzed retrospectively.The 17 patients included 6 cases combined with severe arterial stenosis of lower extremity, 5 cases combined with renal arterial stenosis, 2 cases combined with subclavical arterial stenosis,1 case combined with renal arterial stenosis and femoral arterial occlusion in one side, and 1case combined with thoracic aortic aneurysm.Surgical approaches for the patients with juxtarenal abdominal aortic occlusion included aorto-iliac vascular prosthesis by-pass in 12 cases,axillary-double femoral vascular prosthesis by-pass in 4 cases, and bilateral femoral arteriotomy plus thrombus extraction in one case. The accompanying vascular disease in other vessels were treated by intravascular balloon dilatation and stent insertion, or by femoro-popliteal vascular prosthesis by-pass and aneurysmectomy plus prosthetic vascular replacement.
Results:There was one death in this series. The other 16 cases did not have any severe complications.Lower limb ischemia symptoms was relieved in 16 cases; and 7 cases of lower limb rest pain, 4 cases with hypertension, 2 cases with impaired renal funotion, and 2 cases with dizziness were markedly improved postoperatively.
Conclusions:It is very important that patients with juxtarenal abdominal aortic occlusion combined with vascular disease of other regions of the body should be treated by different surgical approaches, which is the key point to improve patients’survival rate and quality of life.