title: Thrombosed abdominal aortic aneurysm associated with an extensively "shaggy" aorta repaired anatomically via a thoracoabdominal approach with supraceliac aortic clamping: report of a case.
abstract: A 76-year-old man with a history of multiple laparotomies and severe coronary artery disease was referred to our hospital after the sudden development of pain and numbness in the lower extremities. Computed tomography showed a thrombosed abdominal aortic aneurysm and diffuse aortic atherosclerosis; compatible with a "shaggy aorta." A good response to thrombolytic therapy permitted elective scheduling of abdominal aortic surgery after coronary artery bypass grafting. We operated via an extended left retroperitoneal approach through a thoracoabdominal incision. Epiaortic ultrasonography revealed that only the supraceliac aorta was free of mobile thrombi and had minimal plaque; we therefore placed a proximal aortic cross-clamp there. Anatomic aortic reconstruction was then performed successfully using an aorto-biiliac graft to restore adequate distal blood flow. There were no vital-organ ischemic complications, and the postoperative course was satisfactory.
authors.affiliation: Second Department of Surgery, Faculty of Medical Sciences, University of Fukui, Fukui, Japan.
authors.forename: Satofumi
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Tanaka
authors.forename: Koichi
authors.initials: K
authors.lastname: Morioka
authors.forename: Narihisa
authors.initials: N
authors.lastname: Yamada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takamori
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Handa
authors.forename: Akio
authors.initials: A
authors.lastname: Ihaya
authors.forename: Masato
authors.initials: M
authors.lastname: Sasaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000473:pathology*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000473:pathology / Q000601:surgery*; D050197:Atherosclerosis / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007083:Iliac Artery / Q000473:pathology; D008297:Male; D013927:Thrombosis / Q000150:complications / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods