The Acute Abdominal Aorta

Mellnick, Vincent M.; Heiken, Jay P.

doi:10.1016/j.rcl.2015.06.007

Cited by 11 publications

(3 citation statements)

References 81 publications

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“…CTA also provides insight into whether the thrombus is of recent onset, more hyperdense, or chronic, more hypodense (Figure 6A,B). Accurate diagnosis of PAO can be assessed by CTA, which is considered the firstchoice imaging technique in emergency settings [21]. CTA allows for the direct anatomical visualization of the location of the occlusion, visualized as an endoluminal defect in the aortic lumen, and it allows the accurate assessment of concomitant occlusive disease affecting visceral arteries and the type and extent of collateralization, and supports an accurate surgical planning in the reaching of the affected vessel and the type of intervention to be carried out.…”

Section: Discussionmentioning

confidence: 99%

“…Computed tomography (CT) is selected worldwide as the initial test in emergency settings for the diagnosis of acute aortic syndromes [20][21][22]. CT angiography can reach an accurate diagnosis rapidly and allow for near-isotropic voxels and high-quality coronal and sagittal multiplanar reconstructions, as well as three-dimensional (3D)-rendered maximum intensity projection (MIP) and shaded surface display images, all of which can aid in accurate diagnosis and surgical planning [22].…”

Section: Introductionmentioning

confidence: 99%

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Lower Limb Ischemia as Acute Onset of Primary Aortic Occlusion: CTA Imaging and Management

Lassandro¹,

Tamburrini²,

Liguori³

et al. 2023

IJERPH

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Primary aortic occlusion (PAO) is defined as acute occlusion in the absence of aortic atherosclerosis or aneurysm. PAO is a rare disease with acute onset and can determine massive parenchymal ischemia and distal arterial embolization. The aim of our study was to focus on the assessment of clinical characteristic, CT signs, medical and surgical treatment, complication rates and the overall survival of PAO. Materials and Methods: We retrospectively analyzed the data of all patients with acute lower limb ischemia and a final surgical or discharge diagnosis of PAO who underwent aortic CT angiography in ER settings in our hospital from January 2019 to November 2022. Results: A total of 11 patients (8 males/3 females; male/female ratio, 2.66:1, age range 49 to 79 years-old, mean age 65.27 y/o) with acute onset of lower limb impotence or ischemia were diagnosed with PAO. The etiology was thrombosis in all patients. The aortic occlusion was always located in the abdominal aorta and extended bilaterally through the common iliac arteries. The upper limit of the thrombosis was detected in the aortic subrenal tract in 81.8% of the cases, and in the infrarenal tract in 18.2%. A total of 81.8% of the patients were referred to the ER for symptoms related to lower limb: bilateral acute pain, hypothermia and sudden onset of functional impotence. Two patients (18.2%) died before undergoing surgery for multi-organ failure determined by the severe acute ischemia. The other patients (81.8%) underwent surgical treatment that included aortoiliac embolectomy (54.5%), aortoiliac embolectomy + aorto-femoral bypass (18.2%) and aortoiliac embolectomy and right lower limb amputation (9.1%). The overall mortality was 36.4% while the estimated survival at 1 year was 63.6%. Conclusions: PAO is a rare entity with high morbidity and mortality rates if not recognized and treated promptly. Acute onset of lower limb impotence is the most common clinical presentation of PAO. Aortic CT angiography is the first-choice imaging technique for the early diagnosis of this disease and for the surgical treatment, planning and assessment of any complications. Combined with surgical treatment, anticoagulation is considered the first-line medical therapy at the time of diagnosis, during surgical treatment and after at discharge.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lower Limb Ischemia as Acute Onset of Primary Aortic Occlusion: CTA Imaging and Management

Lassandro¹,

Tamburrini²,

Liguori³

et al. 2023

IJERPH

View full text Add to dashboard Cite

show abstract

“…The tangential calcium sign refers to a calcified atherosclerotic plaque that is divergent from the anticipated arc of the aorta adjacent to an area of focal calcium discontinuity. 37 Periaortic hematoma will appear as a focal soft-tissue attenuation arising from the aorta. It is most commonly posterolateral in location but can be circumferential.…”

Section: Aneurysmal Rupturementioning

confidence: 99%