THE aorta at the thoracic or abdominal levels is cross-clamped during surgical procedures for trauma and sometimes for resuscitation; more often, however, it is cross-clamped for surgical treatment of abdominal, thoracic, or thoracoabdominal aneurysm or of peripheral vascular disease complicated by ischemia of the lower extremities, kidneys, or intestines.

Recent studies analyzed the results of thoracoabdominal aneurysm repair and reported discouraging results. Overall 30-day mortality ranged from 8% to 35%.[1-3] The incidence of complete or partial paraplegia was 16-38%; myocardial infarction, 11%; respiratory failure, 36%; renal failure, 18-27%; and gastrointestinal complications, mainly hemorrhage, 7%. Multivariate analysis showed that preoperative renal or pulmonary insufficiency or coronary artery disease increased the rate of complications.[2] Furthermore, this study demonstrated that the duration of aortic cross-clamping also affects the overall results of this surgical intervention. The rate of complications associated with the repair of an abdominal aortic aneurysm is lower and also depends in part on concomitant coronary, pulmonary or renal disease.[4] For example, data on complications of abdominal aortic reconstructive surgery published between 1966 and 1983 demonstrate an overall mortality rate ranging from less than 1% to 15%.[5] In cases of ruptured aortic aneurysms, the mortality rate is 20-42%.[6].