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August 1970

Aorto-Iliac Occlusive Disease: Extension Cephalad to Origin of Renal Arteries, With Surgical Considerations and Results

Author Affiliations

Rochester, Minn
From the Mayo Graduate School of Medicine (University of Minnesota [Dr. Gomes]), and Department of Surgery, Mayo Clinic and Mayo Foundation (Dr. Bernatz), Rochester, Minn.

Arch Surg. 1970;101(2):161-166. doi:10.1001/archsurg.1970.01340260065011

Seventy-one patients with aorto-iliac occlusive disease and associated renalartery stenosis were operated on at the Mayo Clinic. Of these, 65% (46) had hypertension and 18% (13) had chronic renal failure. Revascularization of the lower extremities was performed with bifurcated, knitted Dacron prostheses in all cases. Endarterectomy of the origin of the renal arteries, from inside the aorta, was the most frequent method used to revascularize the kidneys (49 cases). The operative mortality was 6% (four patients). After a mean follow-up of three years, 81% (58) of the patients had significant benefit from revascularization of the lower extremities, and 46% (33) of the hypertensive patients had normal blood pressure. Eight other patients were normotensive when taking a diuretic. The most significant postoperative complication was renal failure, which occurred in 12 cases; it was transitory in six of these.

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