title: Total occlusion of the abdominal aorta in a patient with renal failure and refractory hypertension: a case report.
abstract: Total occlusion of the abdominal aorta is unusual, and potentially catastrophic. It occurs in patients with advanced atherosclerotic occlusive disease, and can cause severe ischemic manifestations, depending on the site of obstruction. Prompt and appropriate diagnostic and therapeutic approaches are important whenever this condition is suspected, in order to avoid a fatal outcome. The development of a complex network of collaterals may prevent the manifestation of acute ischemic phenomena, and cause a delay in diagnosis and treatment. Here we report the clinical case of a 59-year-old man who was referred to our Department for evaluation of renal failure and refractory hypertension. Ultrasonography and 99mTc-DTPA scintigraphy showed a shrunken, non-functioning left kidney, while CT angiography and aortography showed the complete occlusion of the aorta from below the right renal artery down to the bifurcation of both common iliac arteries, with a critical stenosis of the origin of the right renal artery, an occlusion of the left renal artery as well as of the origin of the inferior mesenteric artery. The patient was referred to the surgery department for aorto-bifemoral bypass surgery and re-implantation of the right renal artery.
authors.affiliation: Division of Cardiology - Federico II University of Naples, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Perrino
authors.forename: Laura
authors.initials: L
authors.lastname: Scudiero
authors.forename: Maria Piera
authors.initials: MP
authors.lastname: Petretta
authors.forename: Gabriele Giacomo
authors.initials: GG
authors.lastname: Schiattarella
authors.forename: Mario
authors.initials: M
authors.lastname: De Laurentis
authors.forename: Federica
authors.initials: F
authors.lastname: Ilardi
authors.forename: Fabio
authors.initials: F
authors.lastname: Magliulo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Carotenuto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
mesh_terms: D001012:Aorta, Abdominal; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000601:surgery; D050197:Atherosclerosis / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications*