Is the occlusion of the infrarenal aorta embolic or chronic when efficient collaterals exist?
نویسنده
چکیده
I read with great interest the article entitled ‘Occlusion of the abdominal aorta in a patient with chronic atrial fibrillation’ by Ma et al. [1] that reports a case of intracardiac (left atrial) thrombus with infrarenal occlusion of the abdominal aorta. The legend of Fig. 2 states that the occlusion is of embolic origin. However, the development of such a bypassing collateral vascular network is rather associated with a chronic occlusion. Embolism is an acute event in a patent vessel, manifests as acute aortic occlusion, bypass does not exist, and surgical removal of the emboli is imperative. Acute aortic occlusion (AAO) most commonly results from aortic saddle embolus, in situ thrombosis of a previously atherosclerotic abdominal aorta, sudden thrombosis of small abdominal aortic aneurysms, traumatic elevation of a distal aortic intimal flap, and other rarer etiologies that embolize to the aortic bifurcation. AAO is a different entity than chronic obstruction, where a well-developed collateral circulation may minimize symptoms [2]. The patient probably suffered from aorto-iliac occlusive disease (Leriche syndrome) with significant collateralization [3] and the chronic atrial fibrillation is not associated with the infrarenal aortic occlusion; it simply coexists as concomitant disease and shares common predisposing factors.
منابع مشابه
Internal Thoracic Artery Collateral to the External Iliac Artery in Chronic Aortoiliac Occlusive Disease
OBJECTIVE To evaluate the incidence and angiographic findings of the collateral pathway involving the internal thoracic artery in patients with chronic aortoiliac occlusive disease. MATERIALS AND METHODS Between March 2000 and Februrary 2001, 124 patients at our hospital underwent angiographic evaluation of chronic aortoiliac occlusive disease, and in 15 of these complete obstruction or sever...
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عنوان ژورنال:
- European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
دوره 41 2 شماره
صفحات -
تاریخ انتشار 2012