Journal «Angiology and Vascular Surgery» • 

2001 • VOLUME 7 • №3

THE LONG-TERM RESULTS OF INTRATHORACAL RECONSTRUCTIONS IN PATIENTA WITH ATHEROSCLEROTIC LESIONS OF THE INNOMINATE ARTERY

A.V. Pokrovsky, D.F. Beloyartsev
Department of Vascular Surgery, A.V. Vishnevsky Institute of Surgery, Russian Academy of Medical Sciences,
Moscow, Russia

Analysis was made of the results of 44 consecutive intrathoracal reconstructions performed for atherosclerotic hemodynamically significant lesions of the brachiocephalic trunk. The following operations were accomplished: linear grafting of the innominate artery -30 (68%) and multiple grafting of aortic arch branches – 14 (32%) patients. Of these, seven patients underwent multiple grafting of the right common carotid and subclavian arteries (16%) and another seven patients received multiple grafting of the brachiocephalic trunk and the left common carotid artery (16%). The long-term results were studied in 33 (75%) of the 44 patients. The mean follow-up was 82.2±8.4 months (about 7 years), the maximal constituted 201 months (almost 17 years). The cumulative patency constituted 90% by the l6th year of the follow-up, the cumulative neurologic efficacy of operations reached 80% by the 5th year of the follow-up. Toward the 10th year it dropped to 63% and remained unchanged till the l6th year after operation. The development of graft thromboses was associated with the occurrence of neurologic deficit only in one case. In the long-term period, stroke was the cause of death in none of cases. Based on the analysis of the long-term results the conclusion may be drawn that intrathoracal reconstructions in patients with atherosclerotic hemodynamically significant lesions of the brachiocephalic trunk may be the mehod of choice in the treatment of the given group patients, allowing an appreciable improvement of quality of life and the life-span.

KEY WORDS: atherosclerosis, brachiocephalic trunk, reconstructive operations, long-term results.

P. 58-67

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