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Thrombosis of abdominal aortic aneurysms
H Patel1, M Krishnamoorthy, R A Dorazio
1Department of General Surgery, Kaiser Permanente Medical Center, Los Angeles, CA 90027.
The American Surgeon
|October 1, 1994
Summary
Sudden thrombosis of abdominal aortic aneurysms is a rare surgical emergency. Prompt diagnosis and surgical intervention, including thrombectomy and bypass grafting, lead to successful patient outcomes.
Area of Science:
- Vascular Surgery
- Cardiovascular Medicine
Background:
- Abdominal aortic aneurysms (AAAs) typically present with rupture as the main complication.
- Thrombosis of peripheral aneurysms is common, but AAA thrombosis is rare.
Observation:
- Sudden AAA thrombosis is a surgical emergency with a 50% mortality rate.
- Patients present with symptoms including cool, mottled skin, severe pain, absent femoral pulses, and neurologic deficits.
- A review of four patients revealed varied symptoms like impotence, abdominal and lower extremity pain, coolness, and weakness.
Findings:
- Angiography confirmed complete aortic occlusion in three patients.
- One patient with hemodynamic instability did not undergo angiography.
- Surgical management involved thrombectomy, aneurysmectomy, and bypass grafting, or axillofemoral bypass grafting for patients with severe coronary artery disease.
Implications:
- Prompt diagnosis and surgical management of thrombosed abdominal aortic aneurysms are crucial for successful outcomes.
- This approach can significantly improve patient prognosis in this rare but critical condition.