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Acute aortobiliac graft thrombosis
Marco Leopardi1, Annamaria Maggipinto1, Gennaro Bafile1
1Vascular Surgery Unit, San Salvatore Hospital, University of L'Aquila, Via L. Natali 67100, L'Aquila, Italy.
Annals of Medicine and Surgery (2012)
|June 30, 2021
Summary
Acute limb ischemia is a rare complication following aortic repair. This case highlights sudden graft occlusion one year post-surgery, potentially due to graft kinking, a previously undescribed delayed complication.
Area of Science:
- Vascular Surgery
- Aortic Aneurysm Repair
- Ischemic Complications
Background:
- Acute limb ischemia (ALI) is a known complication after infrarenal aortic repair, typically occurring shortly after surgery.
- This case presents an unusual instance of ALI occurring one year post-abdominal aortic aneurysm (AAA) rupture repair.
Observation:
- A 66-year-old female presented with acute right lower limb ischemia, followed by left lower limb symptoms.
- Computed Tomography Angiography revealed complete occlusion of the infrarenal aorta and aortoiliac graft, with right popliteal artery occlusion.
Findings:
- Emergent embolectomy was performed for the right popliteal artery occlusion.
- Post-operative imaging showed resolution of aortic thrombosis but identified kinking in both graft iliac branches, with chronic left iliac branch occlusion.
Implications:
- This case underscores the possibility of delayed graft occlusion due to kinking, even up to one year after aortic repair.
- It suggests careful long-term surveillance for graft complications, including kinking, in patients who have undergone aortic repair.
