The Clinical Experience of Juxtarenal Aortic Occlusion

Jung, Myung Sun; Koh, Yong Bok; Moon, In Sung; Park, Jang Sang; Kim, Seung Nam

Abstract

PURPOSE: Juxtarenal aortic occlusion (JRAO) was defined as those that extended adjacent to the renal arteries, whereas suprarenal aortic occlusion involved the orifice of at least one main renal artery. The risk of JRAO is due to vital organ ischemic complications involving the kidneys, bowel, or spinal cord. METHOD: During the period from January, 1991 to March, 2000, we experienced 240 patients with chronic aortoiliac occlusive disease at Department of Surgery, Kangnam St. Mary's Hospital, The Catholic University of Korea. Among them, JRAO confirmed by preoperative transbrachial aortography were 19 cases. RESULT: The age of the patients ranged from 42 to 75 years with the mean age of 60 years. All but two were male. Clinical manifestations were presented from intermittent claudication to gangrene with vital organ ischemic changes. The treatment of choice for JRAO is aorto-iliac or aorto-femoral bypass by Dacron graft, with preserving the function of vital organs and preventing the risk of proximal propagation of aortic thrombus.
CONCLUSION
The level of aortic clamping was suprarenal aortic segment in all with the protection of renal arteries by vessel loop and aortic clamping time was 42+/-19 min. Our method of clamping was that advocated by Liddicoat without permanent renal insufficiency.