infrarenal abdominal aorta occlusion

Total occlusion of the abdominal aorta is a rare and life-threatening event. Risk factors most commonly include coagulopathy, vasculitis, trauma, abdominal aortic aneurysms, aortic thromboembolism, and aortic dissection. The most common complications include severe ischemic manifestations in the lower extremities, spinal cord, or viscera. Thus, management is largely dependent on presumed etiology. We present a case of a morbidly obese 52-year-old female with a past medical history of hypertension, diabetes mellitus, peripheral vascular disease, and coronary artery disease with a smoking history of three packs per day for over 10 years...

OBJECTIVES: Fenestrated/branched endovascular aortic repair (F/BEVAR) in patients with occluded iliac arteries is challenging due to limited access for branch vessel catheterization and increased risk for leg and spinal ischemic complications. The aim of this study was to analyze technical strategies and outcomes of F/BEVAR in patients with unilateral iliofemoral occlusive disease (UIOD). METHODS: We performed a retrospective review of all consecutive patients treated by F/BEVAR in two institutions (2003-2021)...

OBJECTIVE: Effectiveness of thoracic endovascular aortic repair in type B aortic dissection is impaired by persistent retrograde false lumen flow via distal re-entry tears. Controlled, stentgraft-assisted balloon dilatation of the true lumen at its lower end, or Knickerbocker technique, may block retrograde false lumen flow and consequently improve effectiveness by inducing immediate thrombosis along the entire descending thoracic aorta. MATERIALS AND METHODS: A single-center retrospective analysis was performed for all consecutive patients with aortic dissection treated with the Knickerbocker technique to block retrograde false lumen flow...

Background: This study aims to investigate the effects of different direct oral anticoagulants on experimental renal injury induced by temporary infrarenal aortic occlusion. Methods: A total of 35 male Wistar rats (250 to 350 g) were randomly allocated to any of the five groups: sham, ischemia-reperfusion, rivaroxaban, dabigatran, and apixaban groups. Sham group underwent median laparotomy. Ischemia-reperfusion group was given saline gavage for one week. Animals in the other groups received rivaroxaban (3 mg/kg), dabigatran (15 mg/kg), or apixaban (10 mg/kg) daily once for one week via oral gavage...

Injury to the inferior vena cava (IVC) can produce bleeding that is difficult to control. Endovascular balloon occlusion provides rapid vascular control without extensive dissection and may be useful in large venous injuries, especially in the juxtarenal IVC. We describe the procedural steps, technical considerations, and clinical scenarios for using the Bridge occlusion balloon (Philips) in IVC trauma. We present a single-center case series of 5 patients in which endovascular balloon occlusion of the IVC was used for hemorrhage control...

A 63-year-old man had presented for emergency endovascular treatment of acute type B aortic dissection complicated by acute occlusion of the true lumen of the infrarenal aorta and a Crawford type III thoracoabdominal aortic aneurysm. These findings precluded the use of a conventional endovascular approach. A novel technique was developed with the insertion of guidewires through the left femoral and subclavian arteries to deliver stent grafts to cover the dissection entry tear and exclude the thoracoabdominal aortic aneurysm...

INTRODUCTION AND IMPORTANCE: Leriche syndrome, also known as aortoiliac occlusive disease, is characterized by chronic obstruction of the abdominal aorta and iliac arteries. The disease was first described by Robert Graham in 1814. Leriche syndrome was named after a French surgeon, Rene Leriche, who first operated on the condition. CLINICAL PRESENTATION: We present a 35-year-old male patient who came to our cardiovascular polyclinic in a wheelchair. He had been complaining for a year about severe back pain, leg cramps on both sides, and weakness in both legs...

OBJECTIVE: This study reports the results of a prospective, multicenter trial designed to evaluate the safety and effectiveness of the polymer based Endologix Alto Stent Graft System in treating abdominal aortic aneurysms (AAA), with sealing seven millimeters below the top of the fabric in aortic neck diameters from 16 to 30mm. METHODS: Seventy-five patients were treated with Alto devices between March 2017 to February 2018 in sixteen centers in the United States for infrarenal abdominal aortic aneurysms (AAA) (max diameter ≥5...

A 67-year-old male patient required surgical management of an abdominal aortic aneurysm. A contrast-enhanced computed tomography showed a saccular infrarenal abdominal aortic aneurysm, with occlusion of the origins of the celiac artery, superior mesenteric artery, and inferior mesenteric artery. An aortography revealed large amounts of blood flow from capillaries around the abdominal aorta to the inferior mesenteric artery and retrograde blood flow to the meandering mesenteric artery through the superior rectal artery...

INTRODUCTION: Penetrating Aortic Ulcer (PAU) is determined by atherosclerotic degeneration of the tunica media with disruption of the intima. Usually it is detected in the thoracic aorta, with only few series describing its abdominal location. Aim of the study was to report early and late outcomes of the endovascular repair of complicated infrarenal PAU (a-PAU) by aorto-bi-iliac endograft and embolization. METHODS: Data of all complicated a-PAU submitted to endovascular repair by aorto-bi-iliac endograft (Cook-Zenith Alpha) between 2016 and 2021(February) were analyzed...

The occurrence of a type IIIa endoleak after endovascular aortic repair is a rare, but crucial, complication leading to rupture. Treatment of a ruptured abdominal aortic aneurysm caused by a type IIIa endoleak can sometimes be challenging. We have reported the case of a 78-year-old man who had presented with a ruptured abdominal aortic aneurysm caused by a type IIIa endoleak resulting from disconnection of a contralateral limb. The patient underwent hybrid repair using manual reconnection of the limbs with laparotomy and an endovascular technique, including balloon occlusion of the infrarenal aorta and new contralateral limb deployment...

Introduction: The aim of this study was to determine the genetic polymorphisms of some antioxidant enzymes together with oxidative stress and the response of some antioxidant enzymes against this situation in vascular and endovascular interventions performed for diseases of the infrarenal abdominal aorta. Material and methods: Twenty-four current or ex-smoker patients (eight aortoiliac occlusive disease (AOD), 16 abdominal aortic aneurysm (AAA)) who were operated were included in this pilot study...

OBJECTIVE: Despite significant improvements in interventional vascular aneurysm repair procedures and intensive care patient management, there has been no significant decrease in mortality due to ruptured abdominal aortic aneurysm. Oxidative stress is known to play a key role in secondary organ damage due to infrarenal aortic clamping. The aim of this study was to examine the potential protective effect of the alpha-2 adrenergic receptor agonist dexmedetomidine (DMT) on aortic occlusion-induced lung injury...

PURPOSE: To directly compare the clinical outcomes of aortobifemoral bypass surgery (ABF) and endovascular treatment (EVT) for chronic total occlusion (CTO) of the infrarenal abdominal aorta (IAA). MATERIALS AND METHODS: In this retrospective, multicenter study, we used an international database of 436 patients who underwent revascularization for CTO of the IAA between 2007 and 2017 at 30 Asian cardiovascular centers. After excluding 52 patients who underwent axillobifemoral bypass surgery, 384 patients (139 ABFs and 245 EVTs) were included in the analysis...

INTRODUCTION AND IMPORTANCE: Arteriomegaly is characterized by an abnormal elastic defect of arterial vessels, which causes them to become elongated and tortuous. This raises the risk of limb loss due to thromboembolism, bleeding, infection, aneurysmal degeneration, dissection, or rupture. Despite asymptomatic presentations, surgical intervention could be warranted to plummet the morbidity and mortality associated with this pathology. CASE PRESENTATION: We report the case of a 70-year-old male who presented with intermittent claudication in the left lower limb at a 100 m...

OBJECTIVE: The aim was to report short and midterm outcomes of a cohort of consecutive patients treated by endovascular aortic repair (EVAR) for saccular lesion of the abdominal aorta (sl-AA). METHODS: This was a multicentre, retrospective, financially unsupported physician initiated, observational cohort study that involved tertiary referral from Italian hospitals. For this study, between January 2010 and December 2020, only those patients treated by EVAR for non-infected sl-AA, namely blister/ulcer like projection and/or penetrating aortic ulcer, were analysed...

BACKGROUND: Recent studies on the Endurant™ endografts mainly compared outcomes of the bimodular stent-graft to other manufacturer's endografts or reported results for cases outside manufacturer's instructions for use (IFU), while data on the experience of standard endovascular aortic repair (EVAR) of infrarenal abdominal aortic aneurysms (AAA) inside manufacturer's IFU comparing the bi- with the trimodular device is limited. METHODS: Inclusion criteria were: 1) infrarenal aneurysms (>50 mm diameter) treated by EndurantTM II (END II) or EndurantTM IIs (END IIs) stent-graft inside manufacturer's IFU; 2) available CTA with 1 mm reconstruction of the entire aorta prior to intervention...

We present a 4-year-old who suffered blunt abdominal trauma leading to Chance fractures to the lumbar spine, bucket-handle injuries to the ileum and descending colon, and an aortic intimal injury leading to occlusion of the infrarenal aorta with extension to the bifurcation. Her vascular injuries were managed by endarterectomy of the intimal injury, thrombectomy of the distal aorta and bilateral iliac arteries using a Fogarty catheter, and patch angioplasty of the infrarenal aorta using bovine pericardium secured by a combination of interrupted and running sutures to optimize elasticity and operative time...

Introduction: Acute thrombosis of an infrarenal abdominal aortic aneurysm (ATAAA) represents an uncommon but catastrophic pathology, which can lead to life threatening complications. This is a report of the infrequent use of an endovascular solution to successfully treat ATAAA in a patient with COVID-19 viral pneumonia and ischaemia induced lower extremity neurological deficits. Report: An 89 year old white male, with a history of cardiovascular comorbidities was admitted to the emergency room with dyspnoea associated with the sudden onset of abdominal and back pain followed by partial motor and sensory deficits in both legs...

RATIONALE: Acute aortic occlusion is an uncommon disease with a high morbidity and high mortality. Clinical symptoms typically include acute lower limb pain, acute paralysis, and absent pulses. We report a very rare case of acute aortic occlusion causing complete paralysis of bilateral lower limbs following microendoscopic laminectomy. PATIENT CONCERNS: A 64-year-old man with hypertension, hyperlipidemia, diabetes, and atrial fibrillation underwent microendoscopic laminectomy for lumbar spinal stenosis...