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.

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.

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.

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 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.

Abstract 15228: Role of Sympathetic Innervation in the Pathogenesis of Abdominal Aortic Aneurysm

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Bin JIANG ◽  
Yugang Liu ◽  
Guillermo A Ameer
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Sympathetic Innervation ◽  
Nerve Fibers ◽  
Elastic Fibers ◽  
Surgical Removal ◽  
Infrarenal Aorta ◽  
Abdominal Aortic ◽  
Nerve Bundles

Introduction: The objective of this study is to understand the role of neurological factors, specifically those from the perivascular sympathetic nervous system (SNS), on the initiation and development of Abdominal Aortic Aneurysm (AAA). Hypothesis: We hypothesize that the formation of AAA is associated with the loss of perivascular SNS-induced vasoconstriction specific to the aneurysm region. Methods: We developed a rat Abdominal Aortic Denervation (AAD) model, where the infrarenal aorta of Spauge Dawley rats was denervated with surgical removal of nerve fibers and chemical denervation with 10% phenol ( Figure. A ). A sham control group was included where the infrarenal aorta was treated with PBS. The arteries were harvested at 1 month after the surgeries for histological assessment. Results: The denervated aortas exhibited significant thinning of the aortic wall including the media and the adventitia, compared to the sham controls ( Figure. B ). Moreover, degradation of elastin, demonstrated by the fragmentation of elastic fibers and the decreased number of lamellar units, was also observed in the dennervated aortas in comparison to the sham controls. While the control aortas were well innervated with perivascular nerve bundles adjacent to the adventitia, no nerves were found surrounding the denervated aortas, suggesting successful denervation. Conclusions: We generated an AAD model that could be used for mechanistic understanding and therapeutic development of AAA. The preliminary data suggest a direct link between the lack of aortic sympathetic innervation and AAA formation. Long-term studies are currently underway to further characterize changes in the aortic walls after sympathetic denervation. Figure. (A) Illustration of the denervated region on the rat infrarenal aorta. ( B ) Histological staining of control and denervated rat abdominal aortas at 1 month after surgery. Yellow stars: para-aortic nerve bundles. Scale bar = 200 μm.

Investigating the Effect of Intraluminal Thrombus in Abdominal Aortic Aneurysm by Computational and Experimental Methods

2009 ◽  
Author(s):  
Florentina Ene ◽  
Carine Gachon ◽  
Patrick Delassus ◽  
Liam Morris
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
High Risk ◽  
Aortic Aneurysm ◽  
Abdominal Aorta ◽  
Experimental Methods ◽  
Infrarenal Aorta ◽  
Intraluminal Thrombus ◽  
Abdominal Aortic ◽  
Risk Of Rupture

Abdominal aortic aneurysm (AAA) represents an abnormal dilatation and weakening of the abdominal aorta with high risk of rupture. Most aneurysms of the infrarenal aorta possess an asymmetrical fusiform morphology.

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