Management of Juxtarenal Aortic Occlusions

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Abstract
"... le traitement idéal consisterait évidement à reséquer la zône obliterée et á retablir la perméabilité arterielle si c'est possible..." —Leriche, 1923 While the syndrome of occlusion of the terminal aorta is frequently observed, the symptom complex caused by aortic obliteration at or above the renal artery level is seldom seen. Occlusion at this higher level usually results from slow proximal progression of a distal aortic thrombosis and insidiously threatens the blood supply to vital organs. The many years of development which this process entails notwithstanding, patients with this end-stage of the Leriche syndrome often remain undiagnosed until their surgical management poses very real problems.9,11,19 The incidence of the Leriche syndrome has not been ascertained but it has been shown that in patients with aortic occlusion who reach vascular centers, from 3% to 15% will have obstruction to flow at the level of the left renal artery.15,28 That

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