A Case Report of Successful Surgical Treatment of High Aortic Occlusion with Acute Ischemia of Intrapelvic Organs and Bilateral Lower Extremities.
10.4326/jjcvs.22.433
- VernacularTitle:急性動脈閉塞症状を呈した高位腹部大動脈閉塞症の１手術例
- Author:
Sadao YOSHIDA
;
Tomoaki JIKUYA
;
Yuji HIRAMATSU
;
Tomonori SHIMADA
;
Yuzuru SAKAKIBARA
;
Naotaka ATSUMI
;
Toshio MITSUI
;
Motokazu HORI
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
1993;22(5):433-436
- CountryJapan
- Language:Japanese
-
Abstract:
This is a case report of a 57-year-old woman with high aortic occlusion (HAO) who had acute symptoms of severe ischemia of the lower extremities and the intrapelvic organs. Generally, HAO is a chronic ischemic disease of the lower extremities and the intrapelvic organs; therefore, acute HAO is relatively rare. Acute thrombotic occlusion of a major collateral artery might be the cause of acute HAO. Laser Doppler flowmetry of the sigmoid colon was useful to evaluate the ischemia of intrapelvic organs. Thrombectomy of the juxtarenal portion with the suprarenal aortic cross clamp was performed within four minutes, then the clamp was moved to the infrarenal portion. The remaining occluded aorta was replaced with a Y-shaped knitted Dacron graft. She had no symptoms after the surgery except renovascular hypertension. Seventy five percent stenosis of the right renal artery was exacerbated to 99%. Vascular clamping of the right renal artery might have been the cause of severe stenosis. Percutaneous transluminal renal angioplasty was successfully performed after the surgery. Aggressive renal artery reconstruction during surgery is recommended in cases with moderate or severe renal artery stenosis.
