Surgical reconstruction for atherosclerosic aortoiliac occlusion
- VernacularTitle:动脉硬化性主髂动脉闭塞症血管重建的术式选择
- Author:
Xiaorun LUO
;
Oinehua WU
;
Zhong CHEN
- Publication Type:Journal Article
- Keywords:
Arteriosclerosis obliterans;
Logistic models;
Vascular surgical procedures;
Aorta abdominal;
Iliac artery
- From:
Chinese Journal of General Surgery
1993;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of anatomic and extra-anatomic reconstruction in cases of aortoiliac occlusion on perioperative morbidity and mortality. Methods Clinical data of 382 cases were retrospectively analyzed with reference to perioperative morbidity and mortality by Logistic regression. Results One hundred and twenty- six patients were enrolled into analysis. Impact factors included lower extremities necrosis(OR 0. 13 95% CI 0. 33 - 0. 36,P=0.005), simultaneous distal reconstruction (OR 11.29 95% CI 1.25 - 102.53,P =0.012). Perioperative complications developed in 13. 5% cases. Goldman cardiac risk(OR 26. 83 95% CI 4. 85 - 49. 54,P =0. 001),age (OR 37. 13 95% CI 3. 29 -48. 53,P = 0. 003),renal dysfunction(OR 5. 71 95% CI 1. 25 -25. 02, P = 0. 024) and surgical modality (OR 0. 03 95% CI 0. 002 - 0. 34, P =0. 005) were identified as risk factors. Perioperative mortality was 8. 7%. Goldman cardiac risk (OR 23. 86 95% CI 3. 90 - 45. 99,P =0. 032),age(OR 65. 56 95% CI 4.88-87.64, P =0.002) and surgical modality(OR 0.02 95% CI 0. 001 -0.262, P=0.005) were among factors predicting perioperative death. Conclusions Age over 70 years, renal dysfunction, intermediate or higher Goldman cardiac risk, moderate or severe emphysema are risk factors of perioperative mortality and morbitity of aortoiliac reconstruction. Extra-anatomic reconstruction should be considered against the risk factors in poor risk patients.
