Aortic bifurcation embolism: a look into the past and nowadays

Melnikov M.V.

Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency;
Pirogov Russian National Research Medical University;
National Research Center Institute of Immunology of the Federal Medical Biological Agency

SPIN RSCI: 6636-6419
Scopus AuthorID: 57221797118
ORCID: 0000-0001-6880-3668

Sotnikov A.V.

Mechnikov North-Western State Medical University

Yakovlev D.A.

Mechnikov North Western State Medical University

Kozhevnikov D.S.

Mechnikov North-Western State Medical University

Koshelev T.E.

Mechnikov North-Western State Medical University

Aortic bifurcation embolism: a look into the past and nowadays

Authors:

Melnikov M.V., Sotnikov A.V., Yakovlev D.A., Kozhevnikov D.S., Koshelev T.E.

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Journal: Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(1): 82‑88

DOI: 10.17116/kardio20231601182

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To cite this article:

Melnikov MV, Sotnikov AV, Yakovlev DA, Kozhevnikov DS, Koshelev TE. Aortic bifurcation embolism: a look into the past and nowadays. Russian Journal of Cardiology and Cardiovascular Surgery. 2023;16(1):82‑88. (In Russ.)
https://doi.org/10.17116/kardio20231601182

Подписка 2025-2 (Russian Journal of Cardiology and Cardiovascular Surgery)

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OBJECTIVE

To analyze clinical course of aortic bifurcation embolism and short-term treatment outcomes.

MATERIAL AND METHODS

There were over 3500 patients with acute limb ischemia following great vessel embolism for 50-year period including 166 (4.7%) ones with aortic bifurcation embolism (the main group). The control group consisted of 1604 patients with iliofemoral arterial embolism.

RESULTS

Severe ischemia of both lower extremities following aortic bifurcation embolism developed rapidly and led to severe disturbances of systemic circulation and endogenous intoxication. Every fifth patient with aortic bifurcation embolism admitted in terminal condition; 134 patients underwent emergency surgery. Embolectomy was performed in 133 cases, primary amputation of both lower limbs — in 1 case. Overall mortality rate including critically ill patients was 62.1%, postoperative mortality — 53%. These values were almost 3 times higher than in the control group. The main cause of death was progressive cardiovascular insufficiency following severe endogenous intoxication.

CONCLUSION

Treatment of patients with aortic bifurcation embolism is still an extremely difficult problem of modern cardiovascular surgery. Urgent restoration of blood flow in extremities and elimination of acute ischemia offer chances for a favorable outcome.

Keywords:

aortic bifurcation embolism

acute limb ischemia

surgical treatment

Authors:

Melnikov M.V.

SPIN RSCI: 6636-6419
Scopus AuthorID: 57221797118
ORCID: 0000-0001-6880-3668

Sotnikov A.V.

Mechnikov North-Western State Medical University

Yakovlev D.A.

Mechnikov North Western State Medical University

Kozhevnikov D.S.

Mechnikov North-Western State Medical University

Koshelev T.E.

Mechnikov North-Western State Medical University

Received:

21.02.2022

Accepted:

20.06.2022

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