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Lethal Complications Associated With Nonrestrictive Treatment of Abdominal Aortic Aneurysms

Lethal Complications Associated With Nonrestrictive Treatment of Abdominal Aortic Aneurysms Abstract • Five high-risk patients received nonresective treatment of abdominal aortic aneurysms (AAAs). This treatment included ligation of the iliac arteries to induce acute thrombosis of AAA and a simultaneous axillobifemoral bypass for restoration of arterial flow to the lower extremities. Of these five patients, lethal complications associated with this procedure developed in four. The complications included rupture, infection of the thrombotic aortic aneurysm, visceral ischemia, and consumptive coagulopathy. This high incidence of lethal complications and the unacceptably high patient mortality in these five patients indicates extreme precaution in the application of nonresective treatment for AAA. (Arch Surg 1982;117:1214-1217) References 1. Szilagyi DE, Smith RF, DeRusso FJ, et al: Contribution of abdominal aortic aneurysmectomy to prolongation of life . Ann Surg 1966;164:678-693.Crossref 2. Hicks GL, Eastland MW, DeWeese JA, et al: Survival improvement following aortic aneurysm resection . Ann Surg 1975;181:863-869.Crossref 3. Volpetti G, Barker CF, Berkowitz H, et al: Twenty-two year review of elective resection of abdominal aortic aneurysms . Surg Gynecol Obstet 1976;142:321-324. 4. Gardner RJ, Gardner HL, Tarnay TJ, et al: The surgical experience and one to 16 year follow-up of 277 abdominal aortic aneurysms . Am J Surg 1978;135:226-230.Crossref 5. Leather RP, Shah D, Goldman M, et al: Nonresective treatment of abdominal aortic aneurysms . Arch Surg 1979;114:1402-1408.Crossref 6. Dubost C, Allary M, Oeconomos N: Resection of an aneurysm of the abdominal aorta: Reestablishment of the continuity by a preserved human arterial graft with the result after five months . Arch Surg 1952;64:405-408.Crossref 7. Flanigan DP, Quinn T, Kraft RO: Selective management of high risk patients with an abdominal aortic aneurysm . Surg Gynecol Obstet 1980;150:171-176. 8. Blaisdell RW, Hall AD, Thomas AN: Ligation treatment of an abdominal aortic aneurysm . Am J Surg 1965;109:560-565.Crossref 9. Berguer R, Schneider J, Wilner HI: Induced thrombosis of inoperable abdominal aortic aneurysm . Surgery 1978;84:425-429. 10. Haaga JR, Baldwin GN, Reich NE, et al: CT detection of infected synthetic grafts: Preliminary report of a new sign . AJR 1978;131:317-320.Crossref 11. Starrett RW, Stoney RJ: Juxtarenal aortic occlusion . Surgery 1974;76:890-897. 12. Gomes MMR, Bernatz PE: Aorto-iliac occlusive disease: Extension cephalad to origin of renal arteries with surgical considerations and results . Arch Surg 1970;101:161-166.Crossref 13. Johnson JK: Ascending thrombosis of abdominal aorta as fatal complications of Leriche's syndrome . Arch Surg 1954;69:663-668.Crossref 14. Wyatt GM, Felson B: Aortic thrombosis as a cause of hypertension: An arteriographic study . Radiology 1957;69:676-683.Crossref 15. Bell JW: Acute thrombosis of the subrenal abdominal aorta . Arch Surg 1967;95:681-684.Crossref 16. Savarese RP, Rosenfeld JC, DeLaurentis DA: Alternatives in the treatment of abdominal aortic aneurysms . Am J Surg 1981;142:226-230.Crossref 17. Getaz EP, Louw JH: The coagulopathy associated with aortic aneurysms . Postgrad Med J 1977;53:668-671.Crossref 18. Keagy BA, Pharr WF, Bowes DE: Unusual presentations of abdominal aortic aneurysms . J Cardiovasc Surg 1981;22:41-46. 19. Johnson WC, Paley RH, Castronuovo JJ, et al: Computed tomographic angiography . Am J Surg 1981;141:434-440.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Lethal Complications Associated With Nonrestrictive Treatment of Abdominal Aortic Aneurysms

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References (24)

Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1982.01380330072018
Publisher site
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Abstract

Abstract • Five high-risk patients received nonresective treatment of abdominal aortic aneurysms (AAAs). This treatment included ligation of the iliac arteries to induce acute thrombosis of AAA and a simultaneous axillobifemoral bypass for restoration of arterial flow to the lower extremities. Of these five patients, lethal complications associated with this procedure developed in four. The complications included rupture, infection of the thrombotic aortic aneurysm, visceral ischemia, and consumptive coagulopathy. This high incidence of lethal complications and the unacceptably high patient mortality in these five patients indicates extreme precaution in the application of nonresective treatment for AAA. (Arch Surg 1982;117:1214-1217) References 1. Szilagyi DE, Smith RF, DeRusso FJ, et al: Contribution of abdominal aortic aneurysmectomy to prolongation of life . Ann Surg 1966;164:678-693.Crossref 2. Hicks GL, Eastland MW, DeWeese JA, et al: Survival improvement following aortic aneurysm resection . Ann Surg 1975;181:863-869.Crossref 3. Volpetti G, Barker CF, Berkowitz H, et al: Twenty-two year review of elective resection of abdominal aortic aneurysms . Surg Gynecol Obstet 1976;142:321-324. 4. Gardner RJ, Gardner HL, Tarnay TJ, et al: The surgical experience and one to 16 year follow-up of 277 abdominal aortic aneurysms . Am J Surg 1978;135:226-230.Crossref 5. Leather RP, Shah D, Goldman M, et al: Nonresective treatment of abdominal aortic aneurysms . Arch Surg 1979;114:1402-1408.Crossref 6. Dubost C, Allary M, Oeconomos N: Resection of an aneurysm of the abdominal aorta: Reestablishment of the continuity by a preserved human arterial graft with the result after five months . Arch Surg 1952;64:405-408.Crossref 7. Flanigan DP, Quinn T, Kraft RO: Selective management of high risk patients with an abdominal aortic aneurysm . Surg Gynecol Obstet 1980;150:171-176. 8. Blaisdell RW, Hall AD, Thomas AN: Ligation treatment of an abdominal aortic aneurysm . Am J Surg 1965;109:560-565.Crossref 9. Berguer R, Schneider J, Wilner HI: Induced thrombosis of inoperable abdominal aortic aneurysm . Surgery 1978;84:425-429. 10. Haaga JR, Baldwin GN, Reich NE, et al: CT detection of infected synthetic grafts: Preliminary report of a new sign . AJR 1978;131:317-320.Crossref 11. Starrett RW, Stoney RJ: Juxtarenal aortic occlusion . Surgery 1974;76:890-897. 12. Gomes MMR, Bernatz PE: Aorto-iliac occlusive disease: Extension cephalad to origin of renal arteries with surgical considerations and results . Arch Surg 1970;101:161-166.Crossref 13. Johnson JK: Ascending thrombosis of abdominal aorta as fatal complications of Leriche's syndrome . Arch Surg 1954;69:663-668.Crossref 14. Wyatt GM, Felson B: Aortic thrombosis as a cause of hypertension: An arteriographic study . Radiology 1957;69:676-683.Crossref 15. Bell JW: Acute thrombosis of the subrenal abdominal aorta . Arch Surg 1967;95:681-684.Crossref 16. Savarese RP, Rosenfeld JC, DeLaurentis DA: Alternatives in the treatment of abdominal aortic aneurysms . Am J Surg 1981;142:226-230.Crossref 17. Getaz EP, Louw JH: The coagulopathy associated with aortic aneurysms . Postgrad Med J 1977;53:668-671.Crossref 18. Keagy BA, Pharr WF, Bowes DE: Unusual presentations of abdominal aortic aneurysms . J Cardiovasc Surg 1981;22:41-46. 19. Johnson WC, Paley RH, Castronuovo JJ, et al: Computed tomographic angiography . Am J Surg 1981;141:434-440.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Sep 1, 1982

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