A modern series of acute aortic occlusion

Crawford, Jeffrey D.; Perrone, Kenneth H.; Wong, Victor W.; Mitchell, Erica L.; Azarbal, Amir F.; Liem, Timothy K.; Landry, Gregory J.; Moneta, Gregory L.

doi:10.1016/j.jvs.2013.10.080

Cited by 79 publications

(97 citation statements)

References 11 publications

(13 reference statements)

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“…All of our patients had CAIO secondary to atherosclerotic aortoiliac occlusive disease, but other causes of CAIO such as embolism, dissection and aortitis have also been described. 1,15,16 We did not see any cases of SRO, but Tapper et al 9 have described an interesting series of 66 patients with CAIO, in which 10 patients (15%) had SRO, with a mortality rate of 9%.…”

Section: Discussionmentioning

confidence: 85%

Surgical treatment of chronic aortoiliac occlusion

et al. 2015

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Background: Chronic aortoiliac occlusion (CAIO) is a significant cause of lower limb ischemia and is often found in young patients who smoke. Objective: To review recent results achieved treating CAIO patients with open surgery. Methods: From November 2011 to April 2014, 21 patients with CAIO were treated at the Santa Casa de Misericórdia, Porto Alegre, Brazil. Demographic data, comorbidities, clinical presentation and surgical results were analyzed. Results: Eleven women and ten men were treated with direct aortic bypass (DAB; n=18) or with extra-anatomic bypass (EAD; n=3). Mean age was 53.7 ± 7.3 years (range: 43-79 years) and all patients smoked. Thirteen patients (62%) had critical ischemia. Six of the patients treated with DAB (33.4%) also required additional revascularization (3 renal and 3 femoropopliteal procedures). Perioperative mortality was zero. Four patients (22.2%) suffered transitory renal dysfunction, but only one patient (5.6%) required hemodialysis. Median follow-up time was 17 months (range: 2-29 months) and there was just one late death, from ischemic heart disease, 7 months after the surgery on the abdominal aorta. Conclusions: Aortic reconstruction is a safe method for treating patients with CAIO, with low perioperative morbidity and mortality rates.

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Section: Discussionmentioning

confidence: 85%

Surgical treatment of chronic aortoiliac occlusion

et al. 2015

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“…We supposed that absence of subjective symptoms might mask the severity of AAO. Because patients with AAO have had poor prognosis without surgical treatment [8–10], we opted for surgical treatment. Surgical alternatives for AAO include simple thromboembolectomy, axillofemoral bypass, aortofemoral bypass, and thrombolytic therapy [8].…”

Section: Discussionmentioning

confidence: 99%

“…Acute aortic occlusion (AAO) is rare among acute arterial occlusive diseases; however, it is still associated with high mortality and morbidity rates [8–10]. The prevalence of PAD among patients with AAO is reportedly 55 to 70 % [9, 10], and the etiology of AAO has shifted from embolic to thrombotic [10].…”

Section: Introductionmentioning

confidence: 99%

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Acute aortic occlusion in a patient with chronic paralysis due to spinal cord injury: a case report

et al. 2016

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Patients with spinal cord injury experience changes in the cardiovascular system and a high morbidity associated with peripheral artery disease. We report a case of acute aortic occlusion in a patient with chronic paralysis due to spinal cord injury. A 65-year-old man with chronic paralysis due to spinal cord injury developed mottling of the right extremity. Because of the complete tetraplegia, the patient had no subjective symptoms. Computed tomography revealed occlusion of the infrarenal abdominal aorta. An emergency thromboembolectomy established adequate blood flow, and the postoperative course was uneventful. The loss of muscle mass might be an advantage in avoiding ischemia reperfusion syndrome. Early detection of acute aortic occlusion and immediate reperfusion are primarily important, but patients with chronic paralysis present a risk of delay in detection, diagnosis, and treatment of acute aortic occlusion because of motor or sensory deficits. Although rare, it is necessary to consider acute aortic occlusion in the case of acute limb ischemia in patients with chronic paralysis due to spinal cord injury.

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“…Rhabdomyolysis is a frequent complication, and the use of additional contrast associated with catheter-based techniques of revascularization may place the patient at increased risk of further renal insufficiency [9].…”

Section: Discussionmentioning

confidence: 99%

Acute Leriche Syndrome due to Embolisation of an Atrial Myxoma

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P²

2015

J Vasc Med Surg

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The presentations of cardiac myxoma are diverse, from asymptomatic to a variety of symptoms due to embolisation. Total occlusion of the abdominal aorta due to embolisation of an atrial myxoma is a rare but lifethreatening event which demands an urgent diagnosis and prompt intervention with embolectomy.In this paper a patient with acute onset paraplegia is presented. CT angiography revealed a large totally occlusive thrombus in the infrarenal abdominal aorta extending into the common iliac arteries. A thrombus in the left atrium was identified as the source of the embolus.Keywords: Atrial myxoma; Acute occlusion of abdominal aorta; Acute Leriche syndrome; TakotsuboCardiomyopathy Case ReportA 68-year-old patient was admitted to the emergency department after a fall during a bike ride because of sudden dizziness. Initially she only had a feeling of discomfort and weakness in the lower extremities en was still able to stand. Shortly afterwards this progressed to paralysis in both legs. Her medical history included diabetes mellitus and active smoking. On admission, the patient was in poor clinical condition with mild tachycardia and fluctuations in blood pressure. She was confused, anxious and sweaty but obeying commands. Clinical examination showed pallor, coldness and paralysis of both legs. Femoral, popliteal and pedal pulses were absent. CT angiography revealed a large totally occlusive thrombus in the infrarenal abdominal aorta extending into the common iliac arteries. A thrombus in the left atrium was identified as the source of the embolus (Figures 1 and 2). Electrocardiography showed ST-segment elevation, consistent with an acute lateral myocardial infarction, and the patient had significantly elevated Troponin I levels. ProcedureIntravenous heparin infusion was started and the patient was transferred to the operation theatre for a bilateral transfemoral embolectomy.Longitudinal groin incisions were made to expose the common femoral arteries and their bifurcation. A size 5 Fogarty was then passed up to the aorta bilaterally with retrieval of a transparent, gelatinous embolus. Biopsies were taken. There was no retrieval of any thrombus distally but there was adequate backflow. Closure of the femoral arteries was done with patch angioplasty after endarterectomy because of severe occlusive pathology. Fasciotomy was not considered because there were no signs of compartment syndrome in the lower extremities. At the end of the procedure both lower extremities were warm and had good capillary refill.

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A modern series of acute aortic occlusion

Cited by 79 publications

References 11 publications

Surgical treatment of chronic aortoiliac occlusion

Surgical treatment of chronic aortoiliac occlusion

Acute aortic occlusion in a patient with chronic paralysis due to spinal cord injury: a case report

Acute Leriche Syndrome due to Embolisation of an Atrial Myxoma

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