Abstract
From 1974 to 1976, four patients with juxtarenal aortic occlusion were operated upon with no surgical mortality. Thromboendarterectomy (TEA) of the aorta with renal revascularization was performed in one patient, and TEA with grafting in three. Intraoperative renal protection was particularly important, since suprarenal aortic clamping was often required in these cases. Possible renal embolism developed in one patient postoperatively. In order to prevent renal embolism and to minimize ischemic insult to the kidney, the value of the following procedures was stressed; (a) irrigation of aortic lumen with saline after TEA under suprarenal aortic clamping with renal arteries kept occluded, and (b) re-application of aortic clamp below the renal arteries after irrigation.
Since the most distal level of occlusive process was the common femoral artery in our series, the patient with this desease entity should be treated more actively.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Yamamoto, N., Hatano, R., Yamada, T., Sunamori, M., Tsuruta, K., Shinohara, H. and Murakami, T.: A new technique to reinforce the site of aorta-vascular prosthesis anastomosis,Shujutsu (Operation). 31: 103–105, 1977 (in Japanese).
Starrett, R.W. and Stoney, R.J.: Juxtarenal aortic occlusion,Surgery. 76: 890–897, 1974.
Johnson, J.K.: Ascending thrombosis of abdominal aorta as fatal complication of Leriche's syndrome,Arch. Surg., 69: 663–668, 1954.
Gomes, M.M.R. and Bernatz, P.E.: Aortoiliac occlusive disease. Extension cephalad to origin of renal arteries, with surgical considerations and results,Arch. Surg. 101: 161–165, 1970.
Bron, K.M.: Thrombotic occlusion of the abdominal aorta,Am. J. Roentgenol. Radium Ther. Nucl. Med. 96: 887–895, 1966.
Starzl, T.E. and Rippel, O.H.: Reno-mesentero-aorto-iliac thromboendarterectomy in patient with malignant hypertension,Surgery 46: 556–564, 1959.
Rob, C.G. and Downs, A.R.: Chronic occlusive disease of the aorta and iliac arteries (Treatment and results),J. Cardiovasc. Surg. 1: 57–64, 1960.
Bergan, J.J. and Trippel, O.H.: Management of juxtarenal aortic occlusions,Arch. Surg. 87: 230–238, 1963.
Chavez, C.M., Conn, J.H. and Gee, H.L.: Surgical treatment of high aortoiliac occlusion,Surgery 65: 757–762, 1969.
DeBakey, M.E., Crawford, E.S., Cooley, D.A. and Morris, G.C. Jr.: Surgical considerations of occlusive disease of the abdominal aorta and iliac and femoral arteries: Analysis of 803 cases,Ann. Surg. 148: 306–324, 1958.
Nunn, D.B. and Kamal, M.A.: Bypass grafting from the thoracic aorta to femoral arteries for high aortoiliac occlusive disease,Surgery 72: 749–755, 1972.
Frøysaker, T., Skagseth, E., Dundas, P. and Hall, K.V.: Bypass procedures in the treatment of obstructions of the abdominal aorta,J. Cardiovasc. Surg. 14: 317–321, 1973.
Frantz, S.L., Kaplitt, M.J., Beil, A.R.Jr. and Stein, H.L.: Ascending aorta-bilateral femoral artery bypass for the totally occluded infrarenal abdominal aorta,Surgery 75: 471–475, 1974.
Cevese, P.G. and Gallucci, V.: Thoracic aorta-to-femoral artery by-pass (For the treatment of complete obstruction of the abdominal aorta at the level of the renal arteries),J. Cardiovasc. Surg. 16: 432–438, 1975.
Hatano, R., Yamada, T., Sunamori, M., Tsukuura, T., Sakamoto, T. and Suzuki, T.: Simplified operative technique for the longsegment atypical coarctation of the aorta,Jap. J. Surg. 5: 246–254, 1975.
Tamiya, T., Kohriyama, H., Ito, T., Ito, K. and Kawakami, H.: Two cases of chronic occlusion of the abdominal aorta—including Leriche's syndrome,Geka (Surgery) 27: 1426–1434, 1965 (in Japanese).
Anazawa, Y., Toyama, K., Suzuki, T., Yagi, Y. and Terjima, H.: Leriche's syndrome,Shujutsu (Operation) 20: 232–240, 1966 (in Japanese).
Koga, M., Nakayama, K., Inatomi, H., Tanioka, K., Futagami, H., Fujise, Y. and Ueki, Y.: Abdominal aortic occlusion,Gekashinryo (Surgical Therapy) 22: 1–11, 1970.
Takao, T., Ohiwa, S., Kaiki, Y., Hibi, H., Onogi, J., Yano, T. and Shimizu, I.: Clinical features of the high abdominal aortic occlusion,Geka (Surgery) 33: 493–497, 1971 (in Japanese).
Yagi, H., Akiyoshi, K., Kawano, Y. and Matsuyama, I.: Operative experience of the abdominal aortic occlusion,Geka (Surgery) 34: 57–64, 1972 (in Japanese).
Ouchi, H., Sasaki, H., Nitta, N. and Kiumura, T.: Surgical treatment of the high abdominal aortic occlusion,Geka (Surgery) 38: 788–792, 1976 (in Japanese).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hatano, R., Tsukuura, T., Sunamori, M. et al. Surgical treatment of juxtarenal aortic occlusion. The Japanese Journal of Surgery 8, 93–101 (1978). https://doi.org/10.1007/BF02469364
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02469364