Long-term results of surgical treatment of infrarenal aortic aneurysms with and without occlusive-stenotic lesions of the ilio-femoral segment

Purpose of the study. To analyze the long-term results (up to 20 years) of open surgical treatment of infrarenal aortic aneurysms with and without occlusive-stenotic lesions of the ilio-femoral segment. Materials and methods. The long-term results of surgical treatment of infrarenal aortic aneurysms were analyzed in 145 patients. Groups: 1 (without lesion IFS, n = 99, 68%) and 2 (with lesion IFS, n = 46, 32%). Observation period: 12±7 years. Results. In group 1, re-interventions were 19% (n = 19), in group 2 – 43% (n = 20; p = 0.003). Primary patency in group 1 was 81% at 20 years, in group 2 – 15% (p<0.001). Freedom from re-interventions in group 1: 5 years – 89%, 10 years – 75%, 20 years – 71%; in group 2: 5 years – 76%, 10 years – 45%, 20 years – 16% (p = 0.001). Limb preservation in group 1 was 91% after 20 years, in group 2 – 52% (p = 0.001). Major amputations: group 1 – 2% (n = 2), group 2 – 15% (n = 7; p = 0.003). Mortality: group 1 – 23% (n = 23), group 2 – 37% (n = 17; p = 0.08). Cumulative survival did not differ: group 1 (5 years – 90%, 10 years – 65%, 20 years – 52%); group 2 (5 years – 85%, 10 years – 54%, 20 years – 36%; p = 0.08). Conclusion: 1. Patients with AAA and lesions IFS have worse remote results after surgery in terms of primary patency, limb salvage and frequency of repeated interventions, but survival does not differ between the groups. 2. In patients with AAA without lesions IFS, repeated interventions are associated with aneurysmal dilation of the thoracic aorta and arteries of the lower extremities. In case of lesions IFS, interventions are caused by branch thrombosis and progressive ischemia of the lower extremities. 3. Regular monitoring of patients after AAA surgery allows for timely detection of complications and correction, which increases the duration and quality of life.