Acute Thrombosis of an Infrarenal Abdominal Aortic Aneurysm Presenting as Bilateral Critical Lower Limb Ischemia

2020 ◽  
pp. 153857442095429
Author(s):  
Hai-Lei Li ◽  
Yiu Che Chan ◽  
Dong-Zhe Cui ◽  
Stephen W. Cheng
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Neurological Deficits ◽  
Leg Pain ◽  
Lower Limb Ischemia ◽  
Acute Thrombosis ◽  
Abdominal Aortic

Background: Intraluminal thrombosis in the aneurysm sac is commonly seen in abdominal aortic aneurysm (AAA). Complete acute thrombosis of an AAA is a rare and catastrophic event. Method: We report a patient with acute AAA thrombosis presenting as bilateral lower limbs critical ischemia. A79-year-old male with a past history of AAA presented with acute onset of bilateral leg pain, coolness, weakness and numbness. His lower extremity pulses including femorals were absent bilaterally on physical examination. Urgent computed tomography angiography showed an infrarenal AAA measuring 45 mm in diameter. The aneurysm sac and bilateral common iliac arteries were completely occluded. Emergency open repair of AAA and bilateral iliac thrombectomy were successfully performed under general anesthesia. Result: Bilateral femoral pulses were present and the neurological deficits were completely resolved after operation. Patient recovered well and was asymptomatic at 3-month follow-up. Conclusion: Acute thrombosis of aortic aneurysm could be an unusual cause of lower limb ischemia, prompt diagnosis followed by surgical revascularization is essential to avoid prolonged ischemia.

“Silent” thrombosis of an abdominal aortic aneurysm not producing acute limb ischemia

VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 265-267 ◽  
Author(s):  
Moulakakis ◽  
Maras ◽  
Bountouris ◽  
Pomoni ◽  
Georgakis ◽  
...  
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Mortality Rate ◽  
Aortic Aneurysm ◽  
Acute Pain ◽  
Limb Ischemia ◽  
Lower Limbs ◽  
Acute Limb Ischemia ◽  
Abdominal Aortic ◽  
Flow Through

Thrombosis of an abdominal aortic aneurysm is a rare devastating complication with an estimated mortality rate of 50%. Simultaneous acute pain, pallor and coldness of the lower limbs, mottling from the level of iliac crests or umbilicus, paraplegia and absence of femoral pulses are all manifestations of a sudden and acute interruption of blood flow through the aneurysmatic aorta. We report a case of an occlusion of an abdominal aortic aneurysm during hospitalization which was not manifested with symptoms of limb ischemia. In this case we feature the rare and unusually “silent” presentation of the event.

scholarly journals Acute Thromboembolism from Trauma in a Patient with Abdominal Aortic Aneurysm

2021 ◽  
Vol 5 (3) ◽  
pp. 357-359
Author(s):  
Solomon Sebt ◽  
Chris Kim ◽  
Wirachin Hoonpongsimanont ◽  
Eric Leroux
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Rare Complication ◽  
Limb Ischemia ◽  
Point Of Care Ultrasound ◽  
Acute Limb Ischemia ◽  
Thromboembolic Events ◽  
Acute Thrombosis ◽  
Abdominal Aortic ◽  
History Of

Case Presentation: A 64-year-old man with a history of a 5.5-centimeter (cm) abdominal aortic aneurysm (AAA) presented to the emergency department (ED) complaining of severe back pain after climbing over a fence and falling a distance of eight feet. Prior to arrival, the prehospital paramedics reported that the patient did not have palpable pulses in either lower extremity. The initial physical examination in the ED was significant for absent dorsalis pedis pulses bilaterally as well as absent posterior tibialis pulses bilaterally and cold, insensate lower extremities. Point-of-care ultrasound identified an approximate 7-cm infrarenal AAA with a mural thrombus present. After receiving several computed tomography (CT) studies including CT head without contrast and CT angiography of the chest, abdomen and pelvis, the patient was diagnosed with acute thrombosis of AAA and associated thromboembolic occlusion of both his right and left distal iliac vessels causing bilateral acute limb ischemia. He immediately received unfractionated heparin and was admitted to the hospital for embolectomy and intra-arterial tissue plasminogen activator. Discussion: Acute thrombosis of AAA and subsequent thromboembolic events are a rare but significant complication that can occur in patients with a history of AAA. Thromboembolic events may occur spontaneously or in the setting of blunt abdominal trauma. Common presenting signs and symptoms include distal limb ischemia and absent femoral pulses. Timely management and recognition of this rare complication is vital as this condition can ultimately result in limb loss or death if not treated in a timely manner. Heparinization after confirmation of non-ruptured AAA as well as vascular surgery, and therapeutic and vascular interventional radiology consultations are key steps that should be taken to decrease patient morbidity and mortality.

Acute thrombosis of abdominal aortic aneurysm presenting with lower limb ischaemia

2011 ◽  
Vol 81 (12) ◽  
pp. 945-946 ◽  
Author(s):  
Bobby V. M. Dasari ◽  
Anthony McBrearty ◽  
Robbie George ◽  
Chris Boyd ◽  
Chee Soong ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Lower Limb ◽  
Limb Ischaemia ◽  
Lower Limb Ischaemia ◽  
Acute Thrombosis ◽  
Abdominal Aortic

scholarly journals Acute Bilateral Lower Extremity Paralysis Secondary to Acute Thrombosis of an Infrarenal Abdominal Aortic Aneurysm

Aorta ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 91-95
Author(s):  
T. Joseph Watson ◽  
W. Kurtis Childers ◽  
Lindsey Haga ◽  
John Calaitges
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Lower Extremity ◽  
Limb Ischemia ◽  
Computed Tomographic Angiography ◽  
Infrarenal Aorta ◽  
Acute Thrombosis ◽  
Bilateral Lower Extremity ◽  
Tibial Arteries ◽  
Abdominal Aortic

AbstractWe present the case of a 64-year-old male who presented to the emergency department with bilateral limb ischemia and paralysis for approximately 1 hour. Computed tomographic angiography demonstrated occlusion of the infrarenal aorta beginning just above the patient’s known abdominal aortic aneurysm (AAA) and extending into both common iliac arteries. He was emergently treated via open repair of the AAA with a Gore-Tex tube graft, bilateral common iliac thrombectomies, and bilateral lower extremity four-compartment fasciotomies. Post-operatively, he had monophasic signals in both posterior tibial arteries, neither of which was present before the operation. During recovery, he developed an ileus but otherwise did not have complications. He was discharged to rehabilitation on post-operative day 15.

scholarly journals An Unusual Case of Acute Thrombosis of Abdominal Aortic Aneurysm without Acute Limb Ischemia

Aorta ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 031-033
Author(s):  
Spyridon Vasdekis ◽  
Sotiria Mastoraki ◽  
Andreas Lazaris ◽  
Konstantinos Moulakakis
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Unusual Case ◽  
Limb Ischemia ◽  
Preoperative Anxiety ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Acute Limb Ischemia ◽  
Acute Thrombosis ◽  
Abdominal Aortic

AbstractAcute thrombosis of an abdominal aortic aneurysm (AAA) is a rare and often devastating complication with high morbidity and mortality. In some cases, however, it may be associated with a silent course without signs of acute limb ischemia. The aim of this report is to describe an unusual case of acute thrombosis of AAA without signs of acute limb ischemia. Preoperative anxiety, stress, and phobia for surgery may be factors predisposing to acute thrombosis of an AAA.

scholarly journals Management of a Mycotic Aneurysm in a Patient with COVID-19: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 620
Author(s):  
Muzammil H. Syed ◽  
Mark Wheatcroft ◽  
Danny Marcuzzi ◽  
Hooman Hennessey ◽  
Mohammad Qadura
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Mycotic Aneurysm ◽  
Neurological Deficits ◽  
Endovascular Stent ◽  
Endovascular Stents ◽  
Abdominal Aortic ◽  
Short Period

The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management.

scholarly journals A 13 cm asymptomatic abdominal aortic aneurysm complicated with arterial obstruction in the left lower limb: A Case report

2021 ◽  
Vol 70 ◽  
pp. 102815
Author(s):  
Sarya Swed ◽  
Salim Tfankji ◽  
Hussein Alkanj ◽  
Tasneem Mohamed ◽  
Nawras Alhalabi ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Lower Limb ◽  
Abdominal Aortic ◽  
Left Lower Limb

scholarly journals Simultaneous surgical treatment of ruptured abdominal aortic aneurysm and acute carotide occlusive disease

2009 ◽  
Vol 56 (1) ◽  
pp. 101-103
Author(s):  
Z.V. Maksimovic ◽  
N. Jakovljevic ◽  
S. Putnik ◽  
D. Jadranin ◽  
D. Markovic ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Surgical Treatment ◽  
Aortic Aneurysm ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Good Condition ◽  
Ruptured Abdominal Aortic Aneurysm ◽  
Acute Thrombosis ◽  
Abdominal Aortic

Combined rupture of abdominal aortic aneurysm and acute thrombosis of internal carotid artery is extremely rare but fatal combination resulting in high mortality rate. Presented case, shows successfully performed simultaneous surgery of ruptured abdominal aortic aneurysm and acute cerebrovascular insult caused by thrombosis of carotid artery in 81 year-old male. Post operative course was uneventfull. At 24 months follow up patient was in good condition, with full neurological recovery. Simultaneous surgical treatment of acute occlusive carotid disease and ruptured abdominal aortic aneurysm (RAAA) seems to be the only life saving procedure for this rare, but very complicated condition. To our knowledge, this is the first reported successful simultaneous surgical treatment of RAAA and acute thrombosis of internal carotid artery.

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