THE DIAGNOSIS AND TREATMENT OF ACUTE AORTIC OCCLUSIONS

Acute occlusion of the abdominal aorta is infrequently observed. The c linical presentation may vary from acute limb ischaemia, neurologic sy mptoms of the lower extremities, abdominal symptoms and acute hyperten sion. This clinical picture is caused by embolic occlusion or, more of ten, by acute thrombosis. Pre-existing atherosclerosis combined with a low flow state because of poor cardiac performance is a relatively fr equent cause of acute aortic occlusion. Hyper-coagulability is observe d as well in association with abdominal arteria thrombosis. The manage ment of this condition includes immediate heparinization and measures to improve the cardiac condition. Although operative treatment by thro mboembolectomy, aortofemoral bypass or axillofemoral bypass is still m ost commonly used management, the present treatment of choice probable consists of thrombolytic therapy and mechanical rheolytic thrombectom y followed by stent placement at severely diseased arterial segments. This latter method is associated with a lower mortality than operative therapy in this high risk patient group.