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aortobifemoral reconstructions

Lazar B Davidovic, Milanko Maksic, Igor Koncar, Nikola Ilic, Marko Dragas, Nikola Fatic, Miroslav Markovic, Igor Banzic, Perica Mutavdzic
OBJECTIVE: To assess results of open repair (OR) of AAA in a single high volume center. METHODS: We analyzed prospectively collected data of 450 patients who underwent elective OR of AAA at the Clinic for Vascular and Endovascular Surgery of the Serbian Clinical Centre in the period between January 2013 and September 2014. RESULTS: Postoperative death occurred in seven patients (1. 55%) during the first 30 postoperative days. The mortality was caused by: uncontrolled bleeding-1, acute myocardial infarction-1, ischemic colitis-2, MOFS-2, sepsis due to infection and dehiscence of laparotomy wound-1...
November 1, 2016: World Journal of Surgery
Kokichi Miyamoto, Mototaka Inaba, Toru Kojima, Takefumi Niguma, Tetsushige Mimura
INTRODUCTION: Secondary aortoduodenal fistula (SADF) is a rare but life-threatening complication after aortic reconstruction. Although a number of reports describing treatments for SADF have been published, the optimal management is unclear. A review of the literature suggested methods of reconstruction, control of bleeding, and reduction of infection in the management of SADF. The most important factor for acute intervention is controlling the bleeding from the fistula. We report one case treated using intra-aortic balloon occlusion (IABO) for SADF...
2016: International Journal of Surgery Case Reports
Carlos A Hinojosa, Javier E Anaya-Ayala, Hugo Laparra-Escareno, Rene Lizola, Adriana Torres-Machorro
The aortic bifurcation and iliac vessels are common sites of atherosclerotic occlusive disease causing the clinical expression known as "Leriche's syndrome". An aortobifemoral bypass grafting in the setting of a septic groin remains a significant challenge to vascular surgeons. We present a 65-year-old male with complete occlusion of the distal aorta and iliac arteries; he had undergone a left axillo-femoral and femoral-femoral artery bypass 2 years prior to our evaluation. Owing to a complex graft infection in the right groin and worsening lower extremity ischemia, we performed an aortobifemoral reconstruction through the right obturator membrane...
June 2016: Vascular Specialist International
Zoltán Oláh, László Hidi, László Entz, Zoltán Szeberin
INTRODUCTION: The adequate exposure of the upper abdominal aorta and its side branches are essential for vascular reconstruction of this region. Besides the traditional transperitoneal, retroperitoneal approach or thoracolaparotomy, left medial visceral rotation (MVR) is an option to explore this hardly accessible region. We present our MVR experiences in aortic surgery. METHODS: Using median or subcostal laparotomy we mobilised the left colon, the spleen, the pancreas and performed dissection in the retroperitoneal area leaving the left kidney in place...
August 2015: Magyar Sebészet
Ildikó Szelechman, Gábor Jancsó, Gergely Vadász, Gábor Kasza, László Sínay, Gábor Fazekas, Péter Hardi, Tibor Nagy, László Benkő, Melinda Gadácsi, Nikoletta Lima, Gábor Menyhei, Endre Arató
INTRODUCTION: In the pelvic region thrombendarterectomy and bypass procedures are the most commonly performed procedures to treat peripheral artery occlusive diseases with chronic, severe circulation failure caused by atherosclerosis. Biologic and synthetic grafts can also be used in bypass surgeries. Application of synthetic grafts can acutely increase the development of the infectious graft complication and its mortality is still between 70 and 75% in pelvic processes. We describe the difficulties and dilemmas of an infectious aortobifemoral graft...
February 2015: Magyar Sebészet
Petar Popov, Slobodan Tanasković, Vuk Sotirović, Srdjan Babić, Dragoslav Nenezić, Djordje Radak
INTRODUCTION: Severe extremity ischemia and the presence of the"blue-toe"syndrome are rarely the first complications of the present abdominal aortic aneurysm.We report two interesting cases of this rare entity. OUTLINE OF CASES: A 61-year-old man presented with the rest pain of his toes accompanied with digital ischemia of both feet. Physical examination confirmed regular arterial pulses at lower extremities accompanied with palpable pulsate mass in the abdomen...
March 2014: Srpski Arhiv za Celokupno Lekarstvo
Amy E Reppert, Omid Jazaeri, Ashok Babu, Joshua I Greenberg, Erica Deluka, Mark R Nehler, Thomas B Reece
BACKGROUND: Endoluminal revascularization has supplanted open techniques for most aortoiliac occlusive disease with open surgery reserved for endovascular failure or long-segment aortoiliac occlusions. A number of clinical and anatomic issues can preclude the use of the infrarenal aorta for inflow. Our approach in these select patients is minimal thoracotomy thoracic bifemoral (mini-TBF) bypass. METHODS: Mini-TBF bypass used a 2-team approach. The cardiac surgery team focused on arterial inflow from the distal descending aorta via a ≤8-cm thoracotomy at ninth interspace...
August 2014: Annals of Vascular Surgery
Sinisa Pejkic, Dragan Opacic, Perica Mutavdzic, Oliver Radmili, Nevena Krstic, Lazar Davidovic
Although mural thrombosis frequently accompanies aneurysmal disease, complete thrombosis is distinctly unusual complication of abdominal aortic aneurysm (AAA). A case study of a patient with chronic, asymptomatic complete thrombosis of a large juxtarenal AAA is presented along with a literature review and discussion of the potential secondary complications, mandating aggressive management of this condition. A 67-year-old man with multiple atherogenic risk factors and unattended complaints consistent with a recent episode of a transient right hemispheric ischemic attack was referred to our clinic with a diagnosis of a thrombosed AAA established by computed tomography...
February 2015: Vascular
Urska Marolt, Stojan Potrc, Andrej Bergauer, Nuhi Arslani, Dino Papes
Secondary aortoenteric fistulas (SAEF) are a relatively rare but dangerous complication of aortal reconstructive surgery. We present a patient that underwent aortobifemoral bypass three years before developing the signs of aortoenteric fistula, and we reviewed the literature on the topic. Since the clinical signs are nonspecific, physicians should have a high index of suspicion for SAEF in patients who underwent aortal reconstructive surgery. The most useful diagnostic tools for stable patients are upper gastrointestinal endoscopy and computed tomography scan with contrast that can, in combination with history and clinical signs, enable accurate diagnosis in more than 90% of patients...
September 2013: Acta Clinica Croatica
V Treska, B Certík, M Cechura, J Molácek, R Sulc, K Houdek
INTRODUCTION: Leriche's syndrome is defined as atherosclerotic occlusion of the infrarenal aorta and/or the iliac axis. It is associated with claudications or critical limb ischaemia and erectile dysfunction in men. MATERIAL AND METHODS: Twenty patients with Leriche's syndrome were operated on at the Department of Surgery, University Hospital in Pilsen between 2008 and 2012. There were 6 women and 14 men of average age 60.3 years (41-76 years). Three patients were in group C and 17 in group D according to the Trans-Atlantic Inter-Society Classification IIb (TASC IIb)...
April 2013: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Antonino Cavallaro, Antonio V Sterpetti, Luca Dimarzo, Paolo Sapienza
BACKGROUND: The goal of this study was to describe and review the results of a technique in which reconstruction of the common and profunda femoral arteries is combined with a femoro-femoral crossover graft using the same synthetic graft. A synthetic bifurcated graft (such as the ones used for aortobifemoral reconstruction), in which one limb is cut off, is used, leaving an enlarging patch at the end where the proximal anastomosis will be fashioned. METHODS: From January 1972 to January 2000, 6 patients underwent this reconstruction for severe limb ischemia...
July 2013: Annals of Vascular Surgery
K Schürmann
CLINICAL ISSUE: Diseases of the aortic bifurcation, whether stenotic or dilating, are mostly a manifestation of arteriosclerosis. If only stenosis is present aortic bifurcation disease is equivalent to a certain form of peripheral arterial occlusive disease (PAOD) characterized by the specific anatomical location. Aneurysmal disease and PAOD of the aortic bifurcation may occur together and men older than 60 years are particularly affected. The main symptom of aortic bifurcation PAOD is bilateral claudication whereas aneurysmal disease of the aortic bifurcation is frequently asymptomatic...
June 2013: Der Radiologe
Nikola S Ilic, Marko Dragas, Igor Koncar, Dusan Kostic, Sinisa Pejkic, Markovic Miroslav, Lazar Davidovic
The infection in vascular surgery is a nightmare of every vascular surgeon. There are numerous ways of treatment but neither one is definitive. We present the case of the patient with infectious limb following aortobifemoral reconstruction treated by partial graft extirpation and with re-implantation of the superficial femoral artery into deep femoral artery.
June 2013: Vascular
Jakub Kaczynski, Steve Atherton, Christopher G Davies, Colin J Ferguson
No abstract text is available yet for this article.
February 20, 2013: BMJ Case Reports
John W York, Brent L Johnson, Michael Cicchillo, Spence M Taylor, David L Cull, Corey Kalbaugh
Vascular bypass has long been the standard surgical treatment for symptomatic aortoiliac occlusive disease (AIOD). Conventional wisdom has been that aortobifemoral bypass (ABF) be performed for AIOD because of the inevitable progression of iliac atherosclerosis leading to bypass thrombosis. However, ABF is prone to significant groin incision complications such as infection and lymphocele. The purpose of this study was to determine if aortobiiliac bypass (ABI) to the distal external iliac artery performs similarly to ABF in cases in which minimal atherosclerosis is present in the distal iliac arteries...
January 2013: American Surgeon
Jerry Matteo, James Cunningham
Conventional revascularization of the lower extremities secondary to aortoiliac atherosclerotic vascular disease (ASVD) involves major intra-abdominal surgery with aortobifemoral bypass grafting. Complication rates are as high as 10% and perioperative mortality can be as high as 5%; therefore, careful patient selection is paramount. Endovascular aortobifemoral bypass repair with aortic bifurcation reconstruction is an emerging option in patients deemed unsuitable for conventional surgical management. Emerging techniques such as snorkel/chimney method are expanding the number of patients who can undergo endovascular repair of abdominal aortic aneurysms and/or revascularization of the lower extremities...
June 2012: Vascular
Manabu Shiraishi, Chieri Kimura, Atsushi Yamaguchi, Hideo Adachi
A secondary aortoenteric fistula is a relatively rare complication of abdominal aortic reconstruction. The clinical manifestation of aortoenteric fistula is usually upper gastrointestinal bleeding. We report a patient who developed acute aortic occlusion following chronic cellulitis, which is an uncommon finding. A 50-year-old man with a history of aortobifemoral bypass grafting was admitted for tiredness, fever and swelling of his right leg. On the 40th day of admission, he developed acute aortic occlusion...
2012: Annals of Thoracic and Cardiovascular Surgery
Anupamaa Seshadri, Christopher Byrne, Andrew Kramer, Stephen T Bartlett, Rajabrata Sarkar
Autosomal dominant polycystic kidney disease is a cause of end-stage renal disease associated with abdominal aortic aneurysms. We report a patient with autosomal dominant polycystic kidney disease who received an allograft kidney and subsequently underwent treatment of an abdominal aortic aneurysm with aortic ligation and axillary-bifemoral bypass. After years of graft function, bypass thrombosis resulted in dialysis-dependent renal failure. Aortobifemoral bypass resulted in immediate restoration of allograft function despite 6 months of prior renal failure...
June 2012: Journal of Vascular Surgery
H Pluhácková, R Staffa, R Vlachovský, T Novotný, M Dvorák
INTRODUCTION: One of the options for the treatment of vascular graft infection in the aortoiliofemoral region is its explantation and extra-anatomical reconstruction. The authors present a rare case of a long-term patent axillobipopliteal bypass. CASE REPORT: A polymorbid patient with complete infection of the aortobifemoral prosthetic graft, with abscess in the groin and bilateral occlusion of the superficial femoral artery was treated by complete graft explantation and implantation of extra-anatomical axillobipopliteal bypass...
October 2011: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Damir Vakhitov, Velipekka Suominen, Georg Pimenoff, Ilkka Uurto, Jukka Saarinen, Juha-Pekka Salenius
BACKGROUND: To report a case of multiple additional procedures after successful endovascular treatment of abdominal aortic aneurysm. METHODS: An endovascular abdominal aortic aneurysm repair with a bifurcated aortic Vanguard endograft successfully performed in 1999 resulted in multiple complications, including endoleaks and a row separation, treated endovascularly. Subsequently, tuberculosis sepsis and prosthesis infection resulted in long-term antibiotic treatment...
May 2012: Annals of Vascular Surgery
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