PMID: 11318137Apr 25, 2001Paper

Fatal diffuse atheromatous embolization following endovascular grafting for an abdominal aortic aneurysm: report of a case

Surgery Today
N ZempoK Esato

Abstract

A 78-year-old woman with an abdominal aortic aneurysm, 57 mm in diameter, was admitted to our hospital for endovascular grafting. Preoperative computed tomography and angiography showed friable mural thrombus in the suprarenal and infrarenal aorta, and a diagnosis of shaggy aorta was made. Postoperatively, the patient suffered cerebral infarction, and disseminated intravascular coagulopathy with multiple organ failure developed, resulting in early death on the third day after surgery. An autopsy revealed diffuse atheromatous embolization into the celiac, superior mesenteric, bilateral renal, bilateral hypogastric (trash buttock), and peripheral arteries. This case report serves to demonstrate that an abdominal aortic aneurysm with a shaggy aorta in the proximal neck is a contraindication to endovascular grafting, and that predicting the possibility of diffuse atheromatous embolization by detecting a shaggy aorta is the best way to prevent this catastrophic complication.

Citations

Sep 13, 2006·Cardiovascular and Interventional Radiology·Barry T Katzen, Alexandra A MacLean
Dec 21, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Junichiro SanadaNoboru Terayama
May 11, 2012·Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia·Daijiro HoriHiroyuki Tanaka
Jan 5, 2014·Annals of Vascular Diseases·Masaru NemotoToshiaki Watanabe
Jan 11, 2012·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·K HoshinaT Miyata
Feb 7, 2012·The Journal of Thoracic and Cardiovascular Surgery·Kyokun UeharaKanji Inoue
Feb 1, 2006·Vascular Medicine·Yin Ping Liew, John R Bartholomew
Jan 2, 2021·Annals of Vascular Diseases·Tsunehiro ShintaniHideaki Obara
Aug 18, 2020·Annals of Vascular Surgery·Raffaele SerraGiuseppe Filiberto Serraino
Mar 16, 2017·Annals of Vascular Surgery·Takashi MurakamiToshihiko Shibata

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