The Treatment of Chronic Atherosclerotic Occlusion of the Lower Limbs – A Review of 30 Cases

Abstract

Atherosclerosis affects large elastic and muscular arteries, the most commonly and severely affected being the aorta. The cerebral, coronary, and renal arteries, and the arteries of the lower limbs are also frequently involved. The principal pathological changes are intimal thickening and fibrous tissue proliferation, which

cause narrowing and occlusion. Ischaemia of -tissues distal to points of obstruction occurs unless adequate collateral channels have had time to develop. Although atherosclerosis is a generalised disease, three main sites of occlusion in the lower limbs are recognised (Macpherson e t al., 1971), the aortic bifurcation (aorto-iliac disease), the superficial femoral artery (femoro-popliteal), and more distant arteries (peripheral).

The purpose of this paper is to review the results of direct arterial surgery to the aorto-iliac vessels in a consecutive series of 30 patients and to correlate them with the indications for surgery and the nature of the lesions as determined by preoperative arteriography.