Chronic occlusion of an abdominal aortic aneurysm

A 67-year-old woman with peripheral arterial occlusive disease in both lower extremities, secondary to an abdominal aortic aneurysm, developed chronic total occlusion of the abdominal aortic aneurysm during the 3-year follow-up period. She suffered from sudden onset of paraplegia 3 months after palliative axillobifemoral bypass grafting and died of pneumonia. The paraplegia was considered to have been caused by thrombosis of lumbar arteries that might have served as an important collateral pathway in the distal spinal cord, due to proximally propagated infrarenal aortic thrombosis. It is necessary to recognize that chronically thrombosed abdominal aortic aneurysm (AAA) still has a risk of causing serious complications with a high mortality rate, especially in cases treated medically or with palliative operations.