REMOTE RESULTS OF AORTOFEMORAL RECONSTRUCTIONS PERFORMED THROUGH MINIACCESS

Maksimov A.V., Galiullin O.F., Plotnikov M.V.
Department of Vascular Surgery, Republican Clinical Hospital of the Health Ministry of the Republic of Tatarstan
Chair of Cardiology and Angiology, Kazan State Medical Academy,
Kazan, Russia

Analysed herein are long-term outcomes of 250 reconstructions of the infrarenal aorta for occlusive disease with the use of transperitoneal miniapproach (median minilaparotomy 5-10 cm long). The patients’ average age amounted to 58.2±0.64 years. 60.4% of patients had critical ischaemia. Bilateral reconstruction was performed in 216 patients, and unilateral – in 34 subjects (with revascularization performed on a total of 466 limbs).

Hospital lethality rate amounted to 0.8% (2 patients). There were 2 bypass-graft thromboses (in one case with successful thrombectomy). The incidence rate of amputations was 0.86% from the number of revascularized extremities.

Remote outcomes were assessed in 145 patients within terms varying from 6 months to 84 months (mean follow-up duration – 30.8±1.4 months). Primary patency after 1 year amounted to 97.0±0.1%, after 5 years – 81.8±3.9%, after 84 months – 67±9.8%, with the corresponding figures for secondary patency amounting to 98.0±0.83%, 91.9±2.8% and 91.9±2.8%, respectively. The limb preservation rate after one year equalled 97.0±0.9%, after 5 years – 93.6±2.4%, after 84 months – 93.6±2.4%. Five-year survival amounted to 73.5±6.2%. Postoperative ventral hernias were revealed in 6.9% of patients.

Hence, the long-term outcomes of aortofemoral reconstructions thorough the miniapproach correspond to the commonly accepted criteria for quality of operations for occlusive pathology of the aortofemoral segment.

KEY WORDS: aortofemoral reconstruction, minilaparotomy, remote outcomes.

P. 170-172

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