Eugster Thomas, Obeid Tamim, Gürke Lorenz, Wolff Thomas, Stierli Peter
University Vascular Center Aarau/Basel, Kantonsspital Basel, CH-4031 Basel, Switzerland.
Ann Vasc Surg. 2005 May;19(3):411-3. doi: 10.1007/s10016-005-0016-2.
A 55-year-old man was admitted with severe pain, paralysis of both legs and absent femoral pulses. Computed tomographic scan demonstrated a 6 cm juxtarenal abdominal aortic aneurysm (AAA) with thrombosis starting at the level of the celiac trunk. At immediate operation, thrombectomy of visceral arteries was performed and distal neovascularization was achieved with a bifurcated prosthesis. It was revealed that all major arteries were occluded with debris. Embolectomy did restore flow in major vessels, but organ perfusion was not achieved due to occlusion of smaller vessels. The patient died with multiorgan failure. This is the first description in the literature of an acutely thrombosed AAA at the supramesenteric level.
一名55岁男性因剧烈疼痛、双腿麻痹且股动脉搏动消失入院。计算机断层扫描显示一个6厘米的肾旁腹主动脉瘤(AAA),血栓形成始于腹腔干水平。在急诊手术中,对内脏动脉进行了血栓切除术,并使用分叉假体实现了远端新血管形成。结果发现所有主要动脉均被碎片阻塞。栓子切除术确实恢复了主要血管的血流,但由于较小血管的阻塞,未实现器官灌注。患者死于多器官功能衰竭。这是文献中首次描述肠系膜上水平的急性血栓形成的腹主动脉瘤。