title: The challenge of posttraumatic thrombus embolization from abdominal aortic aneurysm causing acute limb ischemia.
abstract: We report the first documented case of distal thromboembolism originating from an abdominal aortic aneurysm (AAA) after a blunt trauma. A 72-year-old man with a known 6.2 cm AAA was brought to our emergency department with signs of bilateral acute limb ischemia developing immediately after an accidental fall. The occlusion was confirmed at computed tomographic angiography, and the aneurysm showed a fragmentated/ulcerated mural thrombus, morphologically different as compared to the previous computed tomography (CT). A thromboembolectomy was performed and, after treatment of the ischemic complications, the aneurysm was repaired by open surgery. Embolization from aneurysms in the setting of a trauma is a challenge for the vascular surgeon, also because of its rare occurrence. We describe the management and discuss the operative strategy we opted for in this patient.
authors.affiliation: Department of Surgery, Ospedale Civico di Lugano, Lugano, Switzerland. gl.nigro82@gmail.com
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Nigro
authors.forename: Luca
authors.initials: L
authors.lastname: Giovannacci
authors.forename: Stephan
authors.initials: S
authors.lastname: Engelberger
authors.forename: Jos C
authors.initials: JC
authors.lastname: Van den Berg
authors.forename: Raffaele
authors.initials: R
authors.lastname: Rosso
mesh_terms: D000058:Accidental Falls; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001027:Aortography / Q000379:methods; D017128:Embolectomy; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D017131:Thrombectomy; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome