Surgical management of acute aortic occlusion: A single-center experience

Abstract

Objective: Acute aortic occlusion (AAO) is an uncommon vascular emergency with a high mortality rate of 25%–80%. The management relies heavily on the timely presentation, early recognition, and prompt institution of appropriate treatment to decrease the morbidity and mortality. The objective of this study was to analyze the results of aortic thrombectomy for AAO in our center. Patients and Methods: This retrospective study included ten consecutive patients from November 2014 to July 2015 who presented to the Emergency Department of our hospital with features of AAO. The intraoperative and postoperative data were recorded, and the patients were followed up for 30 months. Results: Of the total of 10 patients, 6 were male. The age range was between 21 and 60 years. Three patients had an identifiable embolic source. The shortest duration of presentation was 12 h while the longest duration was 1 week. Only one patient presented with pain abdomen and vomiting whereas the rest presented with features suggestive of lower-limb ischemia. The mean duration of ischemia and presentation to hospital was 3.33 days in case of embolic etiology while it was 2.64 days in case of thrombotic etiology. We had two postoperative mortalities. Conclusion: AAO though rare has a favorable prognosis irrespective of the duration of presentation depending on the severity of ischemia and end-organ dysfunction at the time of presentation. It also has decreased morbidity and mortality with appropriate and timely treatment. Aortic thrombectomy (infrarenal, suprarenal, or thoracic aorta) is a safe and cost-effective management with less morbidity and mortality.

Keywords

• Acute aortic occlusion
• aortic thrombectomy
• aortofemoral bypass
• surgical management