Ischemic complications of abdominal aortic surgery.

From 1982 through 1988, 634 consecutive patients underwent abdominal aortic reconstruction for occlusive (37%) or aneurysmal (63%) disease. We studied the ischemic problems affecting the branches of the aorta, excluding the coeliac and superior mesenteric arteries. Ischemic colitis (0.6%), spinal cord ischemia (0.16%), renal insufficiency (17%), and lower limbs ischemia (6.5%) were the major problems encountered. We identified the most significant factors associated with these complications such as hypotension, emergency, hypovolemia, preoperative renal function, suprarenal clamping, the quality of the preoperative investigation, and have suggested some specific preventive measures.