학술논문
Open surgical techniques for the management of complex juxtarenal aortic occlusions.
Document Type
Academic Journal
Author
Tracci MC; Division of Vascular and Endovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, VA, USA - msc7s@virginia.edu.; Paterson JE; Division of Vascular Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
Source
Publisher: Edizioni Minerva Medica Country of Publication: Italy NLM ID: 0066127 Publication Model: Print Cited Medium: Internet ISSN: 1827-191X (Electronic) Linking ISSN: 00219509 NLM ISO Abbreviation: J Cardiovasc Surg (Torino) Subsets: MEDLINE
Subject
Language
English
Abstract
The surgical management of aortic occlusive disease can be significantly complicated by the extension of disease, or occlusion, to the level of the renal arteries. The juxtarenal occlusion necessitates careful consideration of operative exposure, technique, and the method and extent of reconstruction. While endovascular techniques have revolutionized the management of occlusive disease of the distal aorta and iliacs, both the presence of bulky, eccentric or exophytic calcification and thrombus at the level of the renal arteries increase the technical difficulty and risk of perforation, stent compromise, or embolization. Disease extending to the visceral segment often necessitates the application of lessons learned in an earlier era and techniques less familiar to the modern surgeon. We will focus on direct, rather than extraanatomic surgical reconstruction.