Related Experiment Videos
Acute aortic occlusion: the need to be aware
A A Zainal1, G Oommen, L G Chew
1Department of Surgery, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur.
Insights
Acute aortic occlusion (AAO) is a rare but deadly vascular emergency. Early diagnosis and surgical intervention are crucial for survival, as this condition has an 82% mortality rate.
Area of Science:
- Vascular Surgery
- Emergency Medicine
Background:
- Acute aortic occlusion (AAO) is a critical vascular condition with significant morbidity and mortality.
- Prompt recognition and management are essential for patient outcomes.
Purpose of the Study:
- To evaluate the clinical characteristics, management, and outcomes of patients with acute aortic occlusion.
- To highlight the importance of early diagnosis and intervention in improving survival rates.
Main Methods:
- A prospective study of 11 patients admitted with acute aortic occlusion over 12 months.
- Data collected included patient demographics, underlying medical conditions, clinical presentation, and treatment modalities.
- Outcomes, including mortality and survival, were analyzed.
Main Results:
- The study included 11 patients, predominantly male (10), with a median age of 58. Hypertension was the most common comorbidity.
- All patients presented with painful lower limb paraparesis/paraplegia and absent pulses.
- The overall mortality rate was high at 82% (9/11), with survivors undergoing vascular reconstructive surgery.
Conclusions:
- Acute aortic occlusion is a rare but catastrophic vascular event with a high mortality rate.
- Clinicians must maintain a high index of suspicion for AAO in patients with suggestive symptoms.
- Early diagnosis, mandatory peripheral pulse examination, and prompt treatment are vital for improving patient outcomes.
Abstract:
A prospective study of patients with acute aortic occlusion (AAO) admitted to the Vascular Unit, Hospital Kuala Lumpur was carried out over a 12 month period. There were a total of 11 patients admitted with a clinical diagnosis of AAO. There was a male preponderance with 10 patients. The median age was 58 years (40-70 years). Hypertension was the commonest underlying medical illness (n = 7). All patients had painful lower limb paraparesis or paraplegia with bilateral absent limb pulses from the groin downwards on admission to the vascular unit. The majority of patients (10 patients) were referred from other hospitals, of which 6 patients came from outside the Klang Valley. Only eight (8) patients underwent an operative procedure with seven (7) having an initial bilateral balloon catheter thromboembolectomy. There was one (1) aorta-bifemoral bypass after failed embolectomy. An aneurysectomy with inlay-graft was done as the initial procedure in one (1) patient. Mortality was 82% (9/11). The two survivors were in the group that had vascular reconstructive surgery. Acute aortic occlusion is an uncommon but catastrophic event with a high mortality. Clinicians must have a high index of suspicion in patients who present with painful paresis or paraplegia. Clinical examination of peripheral pulses in these patients is mandatory. Early diagnosis and treatment is important to improve the outcome of this disease.