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June 1994

Acute Aortic OcclusionA 40-Year Experience

Author Affiliations

From the Division of Vascular Surgery, Department of Surgery, Henry Ford Hospital, Detroit, Mich. Dr Dossa is now with the Division of Vascular Surgery, Staten Island (NY) University Hospital.

Arch Surg. 1994;129(6):603-608. doi:10.1001/archsurg.1994.01420300041006

Objective:  To review a large experience with acute aortic occlusion (AAO) to better define the cause, clinical presentation, treatment, prognostic variables, and outcome.

Design:  Retrospective review of 46 consecutive patients with AAO during a 40-year period.

Setting:  A large urban tertiary care referral center in Detroit, Mich.

Patients:  Adult patients with arteriographic and/or operative confirmation of acute occlusion of the abdominal aorta plus signs and symptoms of acute ischemia.

Intervention:  Operative and nonoperative treatment of AAO.

Main Outcome Measures:  Mortality, morbidity, and long-term survival. Other variables measured included cause, risk factors, and effects of duration and severity of ischemia and treatment methods on outcome.

Results:  Two primary causes were identified—embolism (65%) and thrombosis (35%). Heart disease and female gender were risk factors for embolism, while smoking and diabetes were risk factors for thrombosis. Severity of ischemia on presentation correlated better with outcome than duration of ischemia. The hospital mortality rate was 35% and morbidity, 74%, with no difference between the two groups. Recurrent arterial embolism occurred in 43% of patients with embolic AAO. Seventy-two percent of AAO survivors were alive 5 years after therapy.

Conclusions:  Acute aortic occlusion remains a serious vascular surgical emergency with significant morbidity and mortality, even when recognized promptly and treated appropriately. Nevertheless, survivors have a reasonable long-term outcome. Permanent anticoagulation is suggested in patients with embolic AAO to minimize a high incidence of recurrent arterial embolism.(Arch Surg. 1994;129:603-608)

Webb KH, Jacocks MA.  Acute aortic occlusion . Am J Surg . 1988;155:405-407.Article
Meagher AP, Lord RSA, Graham AR, Hill DA.  Acute aortic occlusion presenting with lower limb paralysis . J Cardiovasc Surg . 1991;32:643-647.
Littooy FN, Baker WH.  Acute aortic occlusion: a multifaceted catastrophe . J Vasc Surg . 1986;4:211-216.Article
Busuttil RW, Keehn G, Miliken J, et al.  Aortic saddle embolus: a twenty-year experience . Ann Surg . 1983;197:698-706.Article
Haimovici H.  Peripheral arterial embolism . Angiology . 1950;1:20-45.Article
Albright HL, Leonard FC.  Embolectomy from the abdominal aorta . N Engl J Med . 1950;242:271-277.Article
Levy JF, Butcher HR Jr.  Arterial emboli: an analysis of 125 patients . Surgery . 1970;68:968-973.
Elliott JP Jr, Hageman JH, Szilagyi E, Ramakrishnan V, Bravo JJ, Smith RF.  Arterial embolization: problems of source, multiplicity, recurrence, and delayed treatment . Surgery . 1980;88:833-845.