Outcomes of Open Aortic Surgery in patients with chronic aorto iliac occlusion - A Clinical study.

Balaji, M (2014) Outcomes of Open Aortic Surgery in patients with chronic aorto iliac occlusion - A Clinical study. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Chronic Aorto iliac occlusion is found in patients with history of diabetes, hypertension, hyperchlosteremia and chronic tobacco use. This condition was first described by Leriche in 1923. Patients with chronic aorto iliac occlusion commonly present with gluteal claudication ,erectile dysfunction and gangrene/tissue loss associated with rest pain of lower limbs There are multiple investigation like segmental ABI, Duplex, CT/MR Angiography, Digital substraction angiography to asses the extent of lesion and physiological severity of these lesion. These investigations also help in deciding the optimal treatment in these cases These lesions are amenable for surgical treatment with low morbidity and mortality in the current era due to advancement in surgical techniques, modern graft, anaesthesia techniques and modern ICU CARE. For these lesions variety of treatment options are available like direct anatomical reconstruction or extra anatomical reconstruction or endovascular treatment. These options enable the operating surgeon to select the most appropriate treatment for the patient considering the co morbidities and the anatomic lesion. Since most of the patients present with diffuse aorto iliac occlusive disease, surgical bypass with graft remains the most effective means of revascularisation and continues to be superior in reliving rest pain, healing of ulcer, and improvement in ABI with low morbidity and mortality. AIM : To study the post operative outcomes and complications of open aortic surgery in patient with chronic aorto-iliac occlusion. CONCLUSION : In our study most of the patient were males 93% Average age group who undergone surgery was 51.9 years. Commonest age group was 50-60 years Most of them were smokers (94%) Commonest risk factors was hypertension (72%), Diabetes (40%) and hyper lipidemia.50% In the study population 28% had coronary artery disease, 21% had chronic obstructive pulmonary disease, and 3% had chronic kidney disease as co –morbidity. Most common indication for surgery was critical limb ischemia (97%) Aorto bi femoral bypass was the commonest surgery done in our study (60%) Mean period of Intensive care unit stay post surgery was 5 days. Prolonged period of Intensive care unit stay post surgery was due to Juxta renal occlusion (50%) cases, cardiac complication (20%) and renal failure(25%). Mean period of hospital stay post surgery was 12 days. Commonest group of hospital stay was 1- 10 days (44%) Prolonged hospital stay was due to wound complication (65%). Mortality in our study was 3%. The cause of mortality in one case was cardiac event and other was disseminated intra vascular coagulation. Improvement in right and left ankle-brachial indices were 0.54±0.25 In our study 99% had relief of rest pain, 98.5% had ulcer healing and nearly all patient had increase in claudication distance. Over all primary patency was 90% in our study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: open aortic surgery ; patients ; chronic aorto iliac occlusion ; A Clinical study.
Subjects: MEDICAL > Vascular Surgery
Depositing User: Kambaraman B
Date Deposited: 24 Jul 2017 03:19
Last Modified: 24 Jul 2017 03:19
URI: http://repository-tnmgrmu.ac.in/id/eprint/2075

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