OCCLUSION OF THE DISTAL AORTA

Between 1984 and 1992, 79 patients were operated for occlusion of the infrarenal abdominal aorta. 12/79 (15%) of the patients underwent emer gency procedure for an acute Leriche syndrome. 67/79 (85%) of the pati ents with a chronic occlusion were treated electively. The surgical ma nagement includes in our series in 57/79 (72%) cases aortoiliac or aor tofemoral prosthetic bypass, in 11/79 (14%) cases aortoiliac endartere ctomy, in 6/79 (8%) cases embolectomy and in 5/79 (6%) extraanatomical axillofemoral bypass. For chronic total occlusion of the aorta the mo st common procedure was prosthetic bypass in anatomical position. For emergency cases embolectomy was performed in 42%. Early morbidity rate was 26% (21/79). The most frequent complications were thromboembolic events in 7 patients, myocardial infarction in 4 patients and renal in sufficiency in 4 cases. The 30-day mortality 2.5% (2/79); the cause in both cases myocardial infarction. For atherosclerotic occlusive disea se of the infrarenal abdominal aorta the prosthetic bypass is the firs t-choice surgical procedure. For embolic occlusions and for risk patie nts other less burdening procedures are available.