BENEFITS OF COMBINED ENDOLUMINAL DILATATI ON AND OPEN SURGERY DURING ELECTIVE ARTERIAL RECONSTRUCTION

Objective: evaluate the benefit of synchronous arterial reconstruction and endoluminal balloon dilatation for occlusive arterial disease dur ing non-urgent procedures. Method: late results of forty arterial reco nstructions combining open surgery with simultaneous endoluminal dilat ation have been reviewed. Balloon dilatation was performed on iliac (N =1 8), femoral (N = 18), popliteal (N = 3) and infra-popliteal arteri es (N = 2). Reasons were rapidity in 31 cases, local reasons in five c ases (such as brievity of available vein for bypass), heavy operative risk in two cases and partial failure of transluminal angioplasty in t wo cases. Results: during the first post-operative month, there were o ne death (due to sepsis) and two reocclusions (one of the dilated arte ry and the other of the bypass). They were successfully reoperated. At the moment of the study, the mean follow-up being thirty months, seve n patients are deceaded (six of them from intercurrent disease), one h as been amputated, three suffer intermittent claudication and twenty-n ine are cured (but eight of them have been reoperated). Conclusion : s ynchronous arterial reconstruction and transluminal dilatation are a g ood option in case of multiple arterial occlusive disease particularly in poor risk patients and when inflow or outflow of bypasses should b e improved. Associated balloon dilatation is very useful in case of to o short vein graft or arterial stenosis due to a clamp injury. Nowaday s in our department, these combined procedures are more and more frequ ent One stage procedure is associated with less complications, shorter lenght of hospitalization and lower cost.