Robaldo Alessandro, Pagliari Stefano, Colotto Patrizio
Division of Vascular and Endovascular Surgery, Imperia Public Hospital, Via Sant'Agata 57, 18100 Imperia, Italy.
Case Rep Surg. 2014;2014:348064. doi: 10.1155/2014/348064. Epub 2014 Oct 7.
We report the diagnostic and successful therapeutic images of an acute occlusion of the abdominal and suprarenal aorta. This lesion is a rare but catastrophic pathology which can cause severe ischemic manifestations, depending on the site of obstruction, with high rate of mortality even after treatment. In the majority of cases it represents a surgical emergency. Although the mechanism of the thrombosis has not been delineated, the proposed etiologies include propagation of thrombus from distal artery occlusion, cardiac thromboembolism, dislodgment of a mural thrombus, or coagulation disorders. Frequent risk factors include advanced atherosclerosis combined with a low flow state because of poor cardiac performance. The management of this condition includes immediate intervention with systemic heparinization, improvement of the cardiac condition, and surgical revascularization based on the clinical and anatomical presentation. In this case the authors highlight the importance of an early detection and early intervention to enhance survival rates and reduce morbidity.
我们报告了一例腹主动脉和肾上腺主动脉急性闭塞的诊断及成功治疗影像。这种病变是一种罕见但灾难性的病理状况,根据梗阻部位不同,可导致严重的缺血表现,即使经过治疗死亡率也很高。在大多数情况下,它代表外科急症。虽然血栓形成机制尚未明确,但推测的病因包括远端动脉闭塞处血栓的蔓延、心脏血栓栓塞、壁血栓脱落或凝血障碍。常见的危险因素包括晚期动脉粥样硬化合并因心功能不佳导致的低血流状态。这种情况的治疗包括立即进行全身肝素化干预、改善心脏状况以及根据临床和解剖表现进行手术血管重建。在此病例中,作者强调了早期检测和早期干预对于提高生存率及降低发病率的重要性。