Journal «Angiology and Vascular Surgery» • 

2001 • VOLUME 7 • №1

SURGICAL TREATMENT OF ARTERIAL ISCHEMIA OF DISTAL SPINAL CORD SEGMENTS IN PATIENTS WITH OCCLUSIVE LESIONS OF THE AORTOFEMORAL ZONE

Yu.V. Chervyakov, Yu.V. Novikov, A.V. Borisov
Department of Vascular Surgery, Yaroslavl Regional Clinical Hospital,
Yaroslavl, Russia

In this paper we analyze the experience gained with the treatment of a group of patients presenting with associated occlusive lesions of the aortofemoral zone and insufficiency of spinal cord circulation. 94 patients with Lerich's syndrome and 18 normal volunteers were examined. The signs of coexistent spinal cord ischemia were present in 16 (17%) patients. Of these, 13 patients, according to the indications, underwent extensive endarterectomy from the abdominal aorta and the iliofemoral segment from two sides, Eleven (86,1%) patients demonstrated regression of the clinical manifestations of spinal cord ischemia and an improvement of the electroneuromyography (ENMG) parameters. Three patients presenting with an abdominal aortic aneurysm underwent typical aortobifemoral grafting. In these patients, we failed to attain any positive dynamics as regards the clinical and ENMG parameters. The authors are of the opinion that it is necessary to take into consideration the signs of chronic spinal cord ischemia when deciding on the type of surgical intervention in patients with occlusive lesions of the abdominal aorta and iliac arteries. In patients suffering from insufficiency of spinal cord circulation, extensive endarterectomy from the infrarenal aorta and the iliofemoral segment is the operation of choice.

KEY WORDS: spinal cord ischemia, electroneuromyography, aortoiliac-femoral occlusion, endarterectomy from the aortoiliac segment.

P. 62

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