Surgical Management for Arteriosclerosis Obliterans Complicated with Ischemic Heart Disease
10.4326/jjcvs.24.238
- VernacularTitle:虚血性心疾患を合併した閉塞性動脈硬化症の外科治療
- Author:
Kiyoshi Inoue
;
Kanji Kawachi
;
Tetsuji Kawata
;
Shuichi Kobayashi
;
Hiroaki Nishioka
;
Yoshihiro Hamada
;
Yoichi Kameda
;
Nobuki Tabayashi
;
Soichiro Kitamura
- Publication Type:Journal Article
- Keywords:
PTCA
- From:Japanese Journal of Cardiovascular Surgery
1995;24(4):238-242
- CountryJapan
- Language:Japanese
-
Abstract:
We studied the incidence of associated ischemic heart disease (IHD) among 110 consecutive patients (males 99, females 11, mean age 66.0±8.8 years) operated upon for arteriosclerosis obliterans (ASO). The screening of IHD was routinely conducted by using dipyridamole thallium scintigraphy, and when results were positive, the lesion was further confirmed by selective coronary angiography. More than 50% luminal stenosis of the major coronary arteries was judged as positive for IHD. Forty-eight patients (44%) of ASO were simultaneously afflicted with IHD. Ten patients were operated on for ASO after coronary artery bypass grafting (CABG), five for ASO and IHD (CABG) simultaneously, eight for ASO after PTCA. Twenty-five patients underwent surgery for ASO only with infusion of nitroglycerin, with or without diltiazem. We also compared 15 patients with thrombotic obliteration at the end of the abdominal aorta o: Leriche's syndrome with the remaining 95 patients in this series. The patients with Leriche's syndrome were younger and had higher incidences of hyperlipidemia (p=0.0254) and IHD (p=0.0225) than those without Leriche's syndrome. In surgical treatment for ASO, particularly for Leriche's syndrome, meticulous attention to complications is needed due to the frequent association of IHD. When both ASO and IHD are severe enough to warrant surgical treatment at the earliest opportunity, we recommend concomitant operations for ASO and IHD (CABG).
