Surgical management of high aortoiliac occlusion

Seventeen patients with high aortoiliac occlusion, 15 chronic and 2 acute, were evaluated at the Walter Reed Army Medical Center during the period 1964-1973. Fifteen patients with chronic occlusion and one patient with an acute occlusion were operated upon without an operative death. The operative technique outlined emphasizes temporary interruption of renal blood flow during the initial aortic thromboendarterectomy phase of the procedure. In those patients in whom renal artery control was secured, no instance of postoperative renal insufficiency was noted. Symptomatic improvement occurred in all patients. Ultimate followup results will be dependent on the amount of associated vascular disease.