Acute infrarenal aortic occlusion

2020 ◽  
Vol 13 (3) ◽  
pp. e233238
Author(s):  
Brianna Barsanti-Innes ◽  
Graham Roche-Nagle
Keyword(s):  
Mortality Rates ◽  
Sudden Onset ◽  
Aortic Occlusion ◽  
Limb Ischaemia ◽  
Perioperative Mortality ◽  
Acute Limb Ischaemia ◽  
The Wire ◽  
Acute Aortic Occlusion

Acute aortic occlusion (AAO) is an uncommon but potentially devastating vascular emergency with reported perioperative mortality rates of up to 75%. We present the case of AAO in a 69-year-old woman who was transferred to our institution after presenting with sudden onset bilateral acute limb ischaemia. Imaging showed a completely obstructed aortoiliac segment with renal infarcts. She was treated successfully with aortoiliac over the wire thrombectomy.

Acute Limb Ischaemia Following Elective Left Upper Lobectomy for Early NSCLC: A Rare but Serious Complication Arising from the Pulmonary Vein Stump

2020 ◽  
pp. 1-2
Author(s):  
James Elliott ◽  
Anand Iyer ◽  
James Elliott
Keyword(s):  
Pulmonary Vein ◽  
Ct Angiography ◽  
Mediastinal Lymph Node ◽  
Case Reports ◽  
Common Femoral Artery ◽  
Sudden Onset ◽  
Leg Pain ◽  
Limb Ischaemia ◽  
Left Upper Lobectomy ◽  
Acute Limb Ischaemia

Patients undergoing Left Upper Lobectomy (LUL) appear to be at risk of a unique post-operative complication that is not well-documented: Pulmonary Vein (PV) stump thrombosis +/- systemic arterial embolisation [1-3]. We describe the details of a rare case from our institution, present a review of this subject from the limited literature available, and suggest potential strategies to anticipate, detect and manage this entity. A 70 year old female patient underwent left upper lobectomy and mediastinal lymph node sampling via repeat left thoracotomy. The procedure was unremarkable apart from some adhesions. She progressed well post-operatively on the ward. On post-operative day 2 the patient developed sudden-onset left leg pain and paraesthesia and CT-Angiography confirmed the diagnosis of left common femoral artery embolus and left superior PV stump thrombosis. The patient returned to theatre for femoral embolectomy, continued systemic anticoagulation, and made an excellent recovery thereafter. The aetiology of this complication has been documented in some case reports, but it is not explored further in trials or thoracic surgery texts [2-3]. One cohort study involving CT-angiography after lobectomy surgeries found that left upper lobectomy was unique as a risk factor for PV stump thrombosis1. It may be related to the relatively longer LSPV stump and stasis of blood in the stump [4].

scholarly journals SS35. Perioperative Mortality and Morbidity After Revascularization for Acute Aortic Occlusion

2018 ◽  
Vol 67 (6) ◽  
pp. e243
Author(s):  
Abhisekh Mohapatra ◽  
Karim M. Salem ◽  
Emade Jaman ◽  
Darve Robinson ◽  
Efthymios (Makis) Avgerinos ◽  
...  
Keyword(s):  
Aortic Occlusion ◽  
Perioperative Mortality ◽  
Mortality And Morbidity ◽  
Acute Aortic Occlusion

scholarly journals Point-of-care Ultrasound Diagnosis of Acute Abdominal Aortic Occlusion

2020 ◽  
Vol 4 (1) ◽  
pp. 79-82
Author(s):  
Benjamin Bloom ◽  
Ryan Gibbons ◽  
Dov Brandis ◽  
Thomas Costantino
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Acute Abdomen ◽  
Point Of Care ◽  
Sudden Onset ◽  
Aortic Occlusion ◽  
Point Of Care Ultrasound ◽  
Diagnosis And Management ◽  
Abdominal Aortic ◽  
Acute Aortic Occlusion

Acute aortic occlusion is an emergent vascular condition not encountered routinely. Given its varied presentations, including neurovascular deficits and mimicking an acute abdomen, the diagnosis is often delayed causing increased morbidity and mortality. We present a case of acute abdominal aortic occlusion masquerading as sudden onset lower extremity pain and weakness in an 86-year-old female requiring emergent thrombectomy. This is only the second case report to discuss the use of point-of-care ultrasound to expedite diagnosis and management.

scholarly journals Acute Aortic Occlusion Presenting as Flaccid Paraplegia

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Ayman Kilany ◽  
Jasem Y. Al-Hashel ◽  
Azza Rady
Keyword(s):  
Back Pain ◽  
Sudden Onset ◽  
Aortic Occlusion ◽  
Sensory Level ◽  
Severe Stenosis ◽  
Iliac Arteries ◽  
Csf Analysis ◽  
Severe Back Pain ◽  
Compressive Myelopathy ◽  
Acute Aortic Occlusion

A 67-year-old male known to be hypertensive and diabetic had a sudden onset of severe low back pain and flaccid paraplegia with no sensory level or bladder affection and the distal pulsations were felt. Acute compressive myelopathy was excluded by MRI of the dorsal and lumbar spines. The nerve conduction study and CSF analysis was suggestive of acute demyelinating polyneuropathy. The patient developed ischemic changes of the lower limb and CT angiography revealed severe stenosis of the abdominal aorta and both common iliac arteries. We emphasize the importance of including acute aortic occlusion in the differential diagnosis of acute flaccid paraplegia especially in the presence of severe back pain even if the distal pulsations were felt.

scholarly journals Risk factors for perioperative mortality after revascularization for acute aortic occlusion

2018 ◽  
Vol 68 (6) ◽  
pp. 1789-1795 ◽  
Author(s):  
Abhisekh Mohapatra ◽  
Karim M. Salem ◽  
Emade Jaman ◽  
Darve Robinson ◽  
Efthymios D. Avgerinos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Occlusion ◽  
Perioperative Mortality ◽  
Acute Aortic Occlusion

scholarly journals A case report of multisite arterial thrombosis in a patient with coronavirus disease 2019 (COVID-19)

2020 ◽  
Author(s):  
Marco Angelillis ◽  
Marco De Carlo ◽  
Andrea Christou ◽  
Michele Marconi ◽  
Davide M Mocellin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Arterial Thrombosis ◽  
Leg Pain ◽  
Nasopharyngeal Swab ◽  
Limb Ischaemia ◽  
Total Occlusion ◽  
Left Common Iliac Artery ◽  
Acute Limb Ischaemia ◽  
The Right

Abstract Background A systemic coagulation dysfunction has been associated with COVID-19. In this case report, we describe a COVID-19-positive patient with multisite arterial thrombosis, presenting with acute limb ischaemia and concomitant ST-elevation myocardial infarction and oligo-symptomatic lung disease. Case summary An 83-year-old lady with history of hypertension and chronic kidney disease presented to the Emergency Department with acute-onset left leg pain, pulselessness, and partial loss of motor function. Acute limb ischaemia was diagnosed. At the same time, a routine ECG showed ST-segment elevation, diagnostic for inferior myocardial infarction. On admission, a nasopharyngeal swab was performed to assess the presence of SARS-CoV-2, as per hospital protocol during the current COVID-19 pandemic. A total-body CT angiography was performed to investigate the cause of acute limb ischaemia and to rule out aortic dissection; the examination showed a total occlusion of the left common iliac artery and a non-obstructive thrombosis of a subsegmental pulmonary artery branch in the right basal lobe. Lung CT scan confirmed a typical pattern of interstitial COVID-19 pneumonia. Coronary angiography showed a thrombotic occlusion of the proximal segment of the right coronary artery. Percutaneous coronary intervention was performed, with manual thrombectomy, followed by deployment of two stents. The patient was subsequently transferred to the operating room, where a Fogarty thrombectomy was performed. The patient was then admitted to the COVID area of our hospital. Seven hours later, the swab returned positive for COVID-19. Discussion COVID-19 can have an atypical presentation with thrombosis at multiple sites.

Limb ischaemia and below-knee amputation following life-saving patent ductus arteriosus stent in a critically ill infant

2014 ◽  
Vol 25 (6) ◽  
pp. 1206-1209
Author(s):  
Apinya Bharmanee ◽  
Srinath Gowda ◽  
Harinder R. Singh
Keyword(s):  
Ventricular Septal Defect ◽  
Patent Ductus Arteriosus ◽  
Septal Defect ◽  
Ductus Arteriosus ◽  
Limb Ischaemia ◽  
Knee Amputation ◽  
Pulmonary Flow ◽  
Life Saving ◽  
Acute Limb Ischaemia ◽  
Patent Ductus

AbstractLimb ischaemia is a rare but catastrophic complication related to cardiac catheterisation. We report an infant weighing 3 kg with unrepaired tricuspid atresia type 1b, small patent ductus arteriosus, and ventricular septal defect presenting with cardiogenic shock owing to progressively reduced pulmonary blood flow from closing ventricular septal defect and patent ductus arteriosus. An emergency palliative ductal stent was successfully placed with marked clinical improvement. However, acute limb ischaemia developed necessitating above-knee amputation, despite medical management and vascular surgery. The cause of limb loss in our patient was catheterisation-related vascular injury causing arterial dissection–arterial thrombosis in the presence of shock and coagulopathy. This report emphasises the complexity in managing limb ischaemia associated with coagulopathy and highlights the importance of early recognition of reduced pulmonary flow in a single ventricle patient. Timely elective placement of a surgical systemic to pulmonary shunt would prevent catastrophic clinical presentation of compromised pulmonary flow and avoid the need for an emergent life-saving intervention and its associated complications.

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