Sm. Taylor et al., THE JUXTARENAL ABDOMINAL AORTIC-ANEURYSM - A MOVE COMMON PROBLEM THANPREVIOUSLY REALIZED, Archives of surgery, 129(7), 1994, pp. 734-737
Objective: To determine the incidence and treatment outcome of juxtare
nal infrarenal aneurysmectomy in a vascular practice minimally biased
by tertiary referral. Design: A 5-year retrospective review of all aor
tic operations from our vascular registry was performed, and a case se
ries of juxtarenal aneurysmectomies was analyzed. Patients: Of 174 inf
rarenal aortic aneurysmectomies performed, 27 (15.5%) (95% confidence
interval, 10.5% to 21.8%)involved the juxtarenal aorta. Interventions:
Juxtarenal involvement was unsuspected but found by aortography in 25
(93%) of 27 cases. Resection was performed transabdominally in 20 cas
es (74%) and retroperitoneally in seven cases (26%). Main Outcome Meas
ures: Incidence, operative technique, morbidity, and mortality were an
alyzed and compared with those of historical controls. Results: The in
cidence of juxtarenal aneurysmectomy was 15.5%. No operative deaths oc
curred, but there was a 19% incidence of surgical morbidity (including
a 7% incidence of transient renal failure). The late survival rate wa
s 89% (follow-up, 1 to 53 months; mean, 18 months). Conclusions: Juxta
renal aortic aneurysms are not uncommon. Successful management is poss
ible, even outside the large referral center.