Acute aortic occlusion

Abstract

Aim: Aim of this article is to present acute aortic occlusion as an emergent vascular event, often called "vascular catastrophe" because of its poor prognosis. It is a diagnostic challenge because it requires early recognition and urgent intervention. We will present two cases of acute aortic occlusion. Case report: In both cases, patients referred to the Emergency Department of the Clinical Hospital Dubrava. Both patients were female, from 55 to 65 years, who presented pain in both legs as deterioration in their condition. One patient had weakness in both legs and neurological symptoms, and the other one had only signs of arterial insufficiency (cold extremities and absence of pulse). In the first case we started with duplex doppler examination, which showed low flow velocities in both superficial femoral arteries with peak systolic velocity lower than 5cm/sec and changed spectra indicating proximal pathology. Multi-slice computerized tomography (MSCT) angiography of abdominal aorta showed thrombosis in infrarenal part of the abdominal aorta which completely filled the lumen. Thrombectomy of the infrarenal aorta was performed. In the second case, we immediately performed MSCT angiography of abdominal aorta by standard protocol in emergency department, which showed complete occlusion of the aorta above the bifurcation and occlusion of both common iliac arteries. Fogarty embolectomy was performed. Discussion and conclusion: Acute aortic occlusion is a rare condition which is easy to overlook, but has a characteristic presentation. A proper indication for imaging methods is of crucial importance for diagnosis of this condition which is treated with surgical methods and has a high mortality.