Abdominal aortic aneurysms associated with visceral arterial stenoses

During a 6-year period six patients had combined revascularizations for an abdominal aortic aneurysm and a high-grade (>80 %) stenosis of either the s uperior mesenteric artery (N = 14) and/or a renal artery (N = 60 including 6 bilateral revascularizations). Revascularizations of a visceral artery we re done more often with a bypass graft (N = 61) than by endarterectomy (N = 6), reimplantation (N = 4) or endovascular technique (N = 3). Fifty patien ts had concomitant repair of the aorta and of the visceral artery, and ten had a staged repair, favored in-high risk patients and in cases of multiple visceral artery revascularizations. Four patients (7,5 %) died (2 myocardi al infarctions and 2 multisystem organ failure) and twelve (20 %) had a non -fatal complication in the postoperative period. Survival was 91 % at one y ear and 81 % at 5 years. Our experience emphasizes the option of a staged approach in these high-ris k patients, with the availability of extra-anatomic reconstruction, and the limited value of endovascular revascularization of the visceral arteries.