Renal and intestinal artery occlusive disease

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AbstractSignificant progress has been achieved in the treatment of renal and intestinal artery occlusive diseases during recent years so that surgery can be performed with good results, with survival in over 95% of patients. Vascular surgeons, therefore, have become more aggressive, frequently combining aortic graft replacement with visceral artery repair. Such operations have become progressively safer, and, in centers in which these operations are performed on a regular basis, morbidity and mortality rates are quite low.The improvement in morphologic and functional results is due to proper selection of patients, adequate preoperative preparation, detailed aortographic investigation, and increased technical experience. The use of simplified reconstructive procedures, refinements in anesthesia, and postoperative care have played a large part in reducing the mortality rate even in complex aortic and visceral artery reconstructions.This is a report of surgical procedures and techniques used in over 800 patients with renal and intestinal artery occlusive disease; 182 of these patients underwent combined aortic and visceral artery, or combined renal and intestinal artery repair. Emphasis is placed on the use of autologous vein grafts in reconstructing renal and intestinal arteries, and attention is paid to technical and hemodynamic details of the different procedures to be preferred. Due to recent advances in surgical techniques, the results of surgical treatment have improved, justifying a more aggressive surgical approach.