Challenging differential diagnosis, Unusual setting of medical care, Patient complains / malpractice, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Bogdan Dutu, Dumitru Zdrenghea, Dana Pop, Gabriel Cismaru, Alexandru Martis, Adrian C. Iancu
(Cardiology Clinic, “Spitalul Clinic De Recuperare”, Cluj Napoca, Romania)
Am J Case Rep 2018; 19:589-592
Aortic occlusion, whether acute or subacute, is a rare but very serious entity with disastrous consequences if not treated in a timely fashion. Rapid diagnosis is crucial in this setting. In surgically treated patients there is a high degree of mortality and morbidity; therefore, percutaneous revascularization, whenever possible and independent of the available techniques, is much more desirable.
CASE REPORT: A 62-year-old woman with a history of diabetes mellitus, dyslipidemia, hypertension, and peripheral vascular disease, with previous femoral-femoral bypass for right common iliac artery occlusion, and with recent conventional angiography showing near occlusion of the ostial left common iliac artery (the donor vessel for the previous bypass), was referred to our hospital for conventional angioplasty. We faced were surprised to find a total infrarenal aortic occlusion and decided to perform emergency and rescue recanalization. We successfully recanalized the aorta and left iliac artery by stent implantation and stabilized the patient, considering that surgical intervention has very high risk for morbidity and mortality in this particular setting.
CONCLUSIONS: Although revascularization is rarely performed in this life-threating condition, endovascular recanalization of a subacute aortic occlusion in a patient with femoral-femoral bypass is feasible and can be life-saving.
Keywords: Aorta, Arterial Occlusive Diseases, endovascular procedures, Stents