Surgical tactics in nonspecific aortoarteritis of the thoracoabdominal region

: Sixty-six patients with nonspecific aortoarteritis of thoracoabdominal localization were treated at the department of vascular surgery of the Vishnevsky Institute of Surgery, AMS USSR from 1984 to 1989. Operations were performed on 49 (74.9%) patients. Percutaneous angiodilatation of the renal arteries was conducted in 3 (4.5%) patients. Nonoperative treatment was carried out in 14 (21.2%) patients. In view of concurrent affection of the branches of the arch of the aorta, reconstructive operations were performed in 16 (24.2%) cases on the brachiocephalic trunks: aorto-biocarotid prosthetics (6), aortocarotid prosthetics (1), subclavian-carotid autovenous prosthetics (6), carotid-subclavian autovenous shunt (2), carotid endarterectomy (1). Reconstructive operations on the brachiocephalic trunks were preceded by reconstruction of the arteries in 5 (7.6%) cases and were conducted after correction of the blood flow in the thoracoabdominal segment in 2 (3%) cases. In 9 (13.6%) patients only the brachiocephalic trunks were reconstructed. A total of 42 reconstructive interventions on the thoracoabdominal segment were carried out on 40 (60.6%) patients, in 35 (87.5%) correction of the blood flow in the visceral branches and renal arteries was performed simultaneously. The surgical tactics suggested by the authors and the results produced by it are discussed in detail.