Surgical Treatment of Aortoiliac Occlusive Disease

ABSTRACT

BACKGROUND: The infrarenal abdominal aorta and the iliac arteries are the most common sites of chronic atherosclerosis in patients with symptomatic occlusive disease of the lower extremities. Direct anatomic reconstruction is the standard surgical treatment for a patient with aortoiliac occlusive disease, but extraanatomic bypass is used in patients with high cardiac or other risks. The purpose of this study was to compare the operative results of direct anatomic reconstruction with those an extraanatomic bypass and to select the optimal surgical treatment according to the preoperative risk. METHOD: The cases of 40 patients who received vascular reconstruction for aortoiliac occlusive disease between January 1995 and October 1997 were reviewed. The patients were classified in two groups a direct anatomic reconstruction group and an extraanatomic bypass group. Operative risks were analyzed by the scoring system recommended by the Subcommittee on Reporting Standards for Lower Extremity Ischemia of International Society for Cardiovascular Surgery (ISCVS). Graft patency, operative mortality, and morbidity were also analyzed for the two groups. RESULT: There was no significant difference in operative risk (p>0.05) between the two groups, but the result of graft patency was better and the postoperative morbidity was less in direct anatomic reconstruction group. There was no postoperative mortality in either group. CONCLUSION: According to this study, direct anatomical reconstruction was superior to extraanatomic bypass inspite of same operative risks.