Acute
arterial occlusion of the aorta
(Portuguese
PDF version)
Coordinated
by Dr. João Luiz Sandri
João Luiz Sandri1, Fábio Luiz Costa
Pereira2
1.
Assistant Professor, Clinical Surgery, Escola Superior de Ciências,
Santa Casa de Misericórdia de Vitória. Vascular Surgeon,
Hospital Metropolitano.
2. Vascular Surgeon, Hospital Metropolitano.
Correspondence:
Dr. João Luiz Sandri
Av. Nossa Senhora da Penha, 714/1006-8
CEP 29055-130 - Vitória - ES
E-mail: jlsandri@escelsa.com.br
J Vasc
Br 2003;2(2):148-9
Part
I - CASE REPORT
A 53-year-old,
smoking male patient with drug-controlled severe hypertension presented
with pain in the left lower extremity (LLE) and sudden limb weakness,
with predominant numbness of the left lower extremity.
On admission to the emergency room, the following was observed: pallor
of lower limbs, more intense on the left side, absence of femoral and
distal pulses of LLE, weak pulse +/4 at right femoral artery and absence
of other pulses in the right lower extremity (RLE).
Since the patient suffered from hypertension and was a smoker, had no
previous vascular history (claudication), presented signs and symptoms
and was clinically diagnosed as having acute occlusion of the aorta,
he was submitted to femoral embolectomy, started on the left side (most
symptomatic). The femoral artery had a normal appearance, without atheromatous
plaques or calcifications. Recent clots and thrombus fragments have
been removed, without good arterial flow after several attempts.
CHALLENGE
·
What should be done now?
· What can you think of in such situation?
· What is the best alternative, without risking the patient's
life?
· Is it possible to perform a thorough and well-documented angiographic
investigation in the operating room?
· Wouldn't it be more convenient to conduct the angiographic
investigation immediately in the hemodynamics laboratory?
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