Acute abdominal aortic occlusion: A 16-year single-center experience

Area of Science:

• Vascular Surgery
• Emergency Medicine
• Cardiovascular Research

Background:

• Acute abdominal aortic occlusion (AAO) presents a significant vascular emergency with high morbidity and mortality rates.
• This study retrospectively analyzed clinical management and outcomes for patients with AAO over a 16-year period.

Purpose of the Study:

• To evaluate the clinical management and outcomes of patients with acute abdominal aortic occlusion.
• To identify trends in treatment and associated mortality and amputation rates over time.

Main Methods:

• Retrospective analysis of 74 patients with acute AAO and bilateral acute limb ischemia treated between 2004 and 2019.
• Exclusion of patients with dissection, aneurysm rupture, or chronic occlusive disease.
• Primary endpoints included 30-day mortality and 6-month amputation/death rates; secondary endpoints included follow-up outcomes and complications. Analysis stratified by 4-year intervals.

Main Results:

• Arterial thrombosis was the most common cause (66%). Overall 30-day mortality was 23%, and 6-month amputation/death rate was 43%.
• Significant decline in 30-day mortality observed from 54% (2004-2007) to 10% (2011-2015), with a trend towards decreased mortality associated with reduced open aortic procedures.
• Elevated serum lactate, advanced limb ischemia, atrial fibrillation, and increased patient age were associated with higher mortality and amputation rates.

Conclusions:

• Acute abdominal aortic occlusion remains a life-threatening condition.
• Immediate transfemoral open or endovascular techniques, when feasible with intraoperative imaging, are recommended for optimal patient outcomes.