ACUTE AORTIC OCCLUSION; DIAGNOSIS,TREATMENT AND FACTORS THAT INFLUENCE OUTCOME

Despite the frequency with which atherosclerosis results in occlusion of the iliac, femor al, p opliteal and distal arteries of the lo­ wer extremities, acute com plete occlusion of aorta is not a common occurance. This report describes 1O patients treated at Ege University, Cardiovascular Surgery Department between 1993-1998 for acute occlusion of abdominal aorta. The etiology of acute occlusion, varied clinic al presentations, management and outcome were reviewed.

Claducation was present ali patients past history except infant patient. Varied degr ee of sudde n onset lower ext emity ische­ mia was most frequent presenting symptom aııd the trombosis was the most common cause of aortic occlusion in our series. Arterial circulation was reestablished in ali patients, with the use of embolectomy in 2, embolectomy and axi llobifemor al b ypass in 3, tra ıısabdom inal aortic trombectomy and Y graft interpositi oıı in 2, axillo-femoral bypas s without embolectomy in 1, en­ darterectomy to visceral art eries and Y graft interposition from thoracic aorta to iliac arteries in 1. Four of 1O patients (%40) were died postoperatively due to severe acidosis and bowel isc h emia. Based on our results, low e jection fr act io ns, severe limb ischemia including parasthesia and paralysis, trombosis of visceral arteries and prior myocardial infarction were correlated with ominous prognosis.

Based on our experience and review of the literature, we propose a systemic approach to the evaluation and treat ment of the­ se critic aliy ili patients which was showed in Table 1.