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Definition
1 - Goal To place a prosthesisafter having putthe aneurysm down flat and extracted the clots. This prosthesis is aorto-aorticor aorto-biliac, or sometimes more extended if the state requires it. 2 - Means Treatment of the aneurysm by implanting a prosthesis whose technique we shall not list. If the patient's state makes an opening of the aorta too perilous, it is possible to exclude it by an axillo-bifemoral bypass surgery. The associated treatment of the other localizations of the atheromatous illness: - Surgical treatment of an occlusion of the carotid artery or a heart artery if necessary. In rare cases, it is possible to make it in the same operative time. - Surgical treatment of an attack of the arteries of the lower limbs by different techniques according to its localization. Indeed, the quality of the arterial downstreamnetwork conditions the permeability of the subjacent graft. 3 - Indications
All aneurysms of the abdominal aorta must be operated. The monitoring up to a 5 cm size is reasonable, the surgical intervention must be considered beyond this size according to the patient's general state. It is thereforemost often a preventive surgery. 4 - Results The results are generally simple with an operative mortality currently <1%. NB: In case of intervention on a rupture, mortality reaches 50% because the operation is very hemorrhagic. 5 - Monitoring However, in 8% of the cases, a complication can occur justifying an immediate post-operative monitoring. It can be: - The myocardial infarction, the most frequent complication. It occurs right after the operation. - The obstruction of the renal arteries that is burdened with an important mortality + The lesion of nervous plexus can lead to an impotence or aretrogradeejaculation in 30% of the cases. The monitoring of the prosthesis is first of all echographic. The atheromatous illness must be treated assuch (stoppage of cigarettes smoking, reduction of weight, practice of a regular physical activity, antihypertensive and hypocholesterolemiant treatment if needed).
The discovery of an aneurysm of the abdominal aorta is most often a discovery
of systematicclinical exam. The preoperative check-up focuses on the aneurysm
and on the various localizations of the atheromatous illness that can also be
operated. Consequently, an aneurysm of the abdominal aorta is currently a pathology
with a good prognosis.
File last reviewed on dec 18, 2011 |
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