title: Chronic complete thrombosis of abdominal aortic aneurysm: an unusual presentation of an unusual complication.
abstract: Although mural thrombosis frequently accompanies aneurysmal disease, complete thrombosis is distinctly unusual complication of abdominal aortic aneurysm (AAA). A case study of a patient with chronic, asymptomatic complete thrombosis of a large juxtarenal AAA is presented along with a literature review and discussion of the potential secondary complications, mandating aggressive management of this condition. A 67-year-old man with multiple atherogenic risk factors and unattended complaints consistent with a recent episode of a transient right hemispheric ischemic attack was referred to our clinic with a diagnosis of a thrombosed AAA established by computed tomography. Duplex ultrasonography and aortography confirmed the referral diagnosis and also revealed near occlusion of the left internal carotid artery. The patient underwent a two-stage surgery, with preliminary left-sided carotid endarterectomy followed three days later by an aneurysmectomy and aortobifemoral reconstruction. He had an uncomplicated recovery and was discharged home on postoperative day 7, remaining asymptomatic at the 42-month follow-up. Complete thrombosis is an uncommon presentation of AAA and may be clinically silent. It is frequently associated with other manifestations of generalized atherosclerosis. Radical open repair yields durable result and is the preferred treatment modality.
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Sinisa
authors.initials: S
authors.lastname: Pejkic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia d.opacic@yahoo.com.
authors.forename: Dragan
authors.initials: D
authors.lastname: Opacic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Perica
authors.initials: P
authors.lastname: Mutavdzic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Oliver
authors.initials: O
authors.lastname: Radmili
authors.affiliation: Clinic for Physical medicine and rehabilitation, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Nevena
authors.initials: N
authors.lastname: Krstic
authors.affiliation: Clinic for Vascular and Endovascular Surgery, Clinical Center of Serbia, Belgrade, Serbia Faculty of Medicine, University of Belgrade, Serbia.
authors.forename: Lazar
authors.initials: L
authors.lastname: Davidovic
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D058070:Asymptomatic Diseases; D019917:Blood Vessel Prosthesis Implantation; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D002908:Chronic Disease; D016894:Endarterectomy, Carotid; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
keywords: Abdominal aortic aneurysm; aneurysm thrombosis; aneurysmectomy; atherosclerosis; collateral circulation