CURRENT TREATMENT STRATEGIES FOR ACUTE DI STAL AORTIC OCCLUSION

Forty-eight acute distal aortic occlusions were treated on an inpatien t basis from January 1973 to December 1993. The mean age was 66 years. Twenty-seven patients had an acute thrombotic occlusion of the distal aorta, and a cardiogenic embolism was the cause of occlusion in 21 ca ses. The 43 operated patients evidenced a hospital mortality of 32.6% (14/43) and an amputation rate of 7% (3/43). Reperfusion was achieved in 20 patients solely by remote thromboembolectomy with the aid of a F ogarty catheter. A TEA and patch graft were performed in six patients; an extra-anatomic bypass was established in 9 cases and an aortobifem oral bypass in 8. Severe accompanying cardiac diseases were predominan t in the patients with an embolic occlusion, whereas severe arterioscl erotic risk factors prevailed in all those with thrombotic occlusions. The mortality among our patients showed a statistically significant ( p<0.05) correlation only with the preoperative ischemia time.