Korean J Thorac Cardiovasc Surg.  2015 Jun;48(3):187-192. 10.5090/kjtcs.2015.48.3.187.

The Role of Extra-Anatomic Bypass in the Surgical Treatment of Acute Abdominal Aortic Occlusion

• Ilhan G
• Bozok S
• Ergene S
• Karakisi S
• Tufekci N
• Kazdal H
• Ogullar S
• Kucuker SA

• KMID: 2382254
• DOI: http://doi.org/10.5090/kjtcs.2015.48.3.187

Abstract

BACKGROUND
Aortic occlusion is rare catastophic pathology with high rates of mortality and severe morbidity. In this study, we aimed to share our experience in the management of aortic occlusion and to assess the outcomes of extra-anatomic bypass procedures.
METHODS
Eighteen patients who had undergone extra-anatomic bypass interventions in the cardiovascular surgery department of our tertiary care center between July 2009 and May 2013 were retrospectively evaluated. All patients were preoperatively assessed with angiograms (conventional, computed tomography, or magnetic resonance angiography) and Doppler ultrasonography. Operations consisted of bilateral femoral thromboembolectomy, axillobifemoral extra-anatomic bypass and femoropopliteal bypass and were performed on an emergency basis.
RESULTS
In all patients during early postoperative period successful revascularization outcomes were obtained; however, one of these operated patients died on the 10th postoperative due to multiorgan failure. The patients were followed up for a mean duration of 21.2+/-9.4 months (range, 6 to 36 months). Amputation was not warranted for any patient during postoperative follow-up.
CONCLUSION
To conclude, acute aortic occlusion is a rare but devastating event and is linked with substantial morbidity and mortality in spite of the recent advances in critical care and vascular surgery. Our results have shown that these hazardous outcomes may be minimized and better rates of graft patency may be achieved with extra-anatomic bypass techniques tailored according to the patient.

Keyword

Abdominal aorta; Aortic occlusion; Vascular surgery; Therapeutics; Extra-anatomic bypass

MeSH Terms

Amputation
Aorta, Abdominal
Critical Care
Emergencies
Follow-Up Studies
Humans
Mortality
Pathology
Postoperative Period
Retrospective Studies
Tertiary Care Centers
Transplants
Ultrasonography, Doppler