Dystrophy of the media with aneurysmal tendency in the abdominal aorta-iliac segments (13 cases).

The authors report 13 cases of aneurysm of the abdominal aorta and common iliac arteries similar to those described by Leriche. The main morphological abnormality was major dystrophy involving the media, giving a special pathological appearance to these structures, long considered a mere morphological anomaly. In this part of the arterial system at least, they seem to evolve towards aneurysm and rupture (thin-walled aneurysm). This course requires echotomographic supervision of cases not submitted to immediate surgery, owing to the widespread nature of the process and the fact that some lesions resemble large arteries rather than aneurysms. The classic surgical technique of aortic and iliac aneurysms should often also include special technical devices. First, unilateral by-pass operation before the resection stage, and secondly aortic suture on a prosthesis to avoid tearing the arterial wall which is affected by media-spongiosis. The ten cases operated here all had a favourable course with a follow-up period of 1 to 9 years.