SURGICAL TACTICS IN REOCCLUSIONS IN THE A ORTOILEO-FEMORAL SEGMENT

At the department of vascular surgery of the Novgorod Regional Hospita l 455 reconstructive operations for atherosclerotic occlusions in the aorto-ileo-femoral segment were performed in 1984-1991. Thrombotic reo cclusion occurred in 58 patients (12.7 %) for which a second operation had to be conducted, early thromboses of the reconstructed segment we re encountered in 16 patients (3.5 %) and late thromboses in 42 (9.2 % ). The work analyses the causes of early and late reocclusions, substa ntiates the surgical tactics, and discusses the technical characterist ics of the operation. Thrombectomy with reconstruction of the distal a nastomosis and the draining paths was the main method of treatment. It was conducted in 12 patients with early and in 21 patients with late reocclusions. The results of surgical treatment are shown. It is concl uded that repeated reconstructive operations are a sufficiently effect ive measure for preserving the function of the earlier operated on lim b; they made it possible to produce positive immediate results in 81.0 % and late-term results in 64.3 % of patients.