BACKGROUND: Acute aortic occlusion most commonly results from aortic s
addle embolus or thrombosis of an atherosclerotic abdominal aorta. The
purpose of this study was to review the experience at a university ho
spital to better define the diagnosis and management of this uncommon
process. METHODS: A retrospective chart review was performed from pati
ents admitted to Emery University Hospital with acute occlusion of the
abdominal aorta from 1985 through 1997. RESULTS: Thirty-three patient
s were identified. In group EMB (n = 16), occlusion was due to saddle
embolus. In group IST (n = 17), occlusion was attributed to in situ th
rombosis of a severely diseased aorta. Operative procedures performed
included transfemoral embolectomy (15), aortobifemoral bypass (9), axi
llobifemoral bypass (5), fasciotomy (3), and thrombolysis (1). The in-
hospital mortality rate was 21% (31% EMB, 12% IST), and morbidity was
significant and included mesenteric ischemia (6%), bleeding complicati
ons (9%), subsequent amputation (12%), renal failure (15%), recurrent
embolization or thrombosis (21%), and cardiac complications (42%). CON
CLUSIONS: Acute aortic occlusion has tremendous morbidity and mortalit
y even with optimal surgical care. Am J Surg. 1998;176:193-197. (C) 19
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