Acute Aortic Occlusion of Abdominal Aortic Aneurysm and Bilateral Common Iliac Artery Aneurysm

Abstract

A 63-year-old man presented to our hospital with sudden pain in both lower extremities. Computed tomography showed abdominal aortic aneurysm and bilateral common iliac artery aneurysms filled with thrombosis and occlusion of the right popliteal artery. We performed an emergency operation. A midline abdominal incision was made to expose the abdominal aortic aneurysm and bilateral common iliac artery aneurysm. Using a 16×8 mm bifurcated prosthesis (Hemashield Platinum), the proximal end of the graft was anastomosed to the abdominal aorta below the bilateral renal arteries. The right common femoral artery was incised longitudinally to remove the thrombosis from the right popliteal artery, after which the right leg of the graft was guided to the right groin, and an end-to-side anastomosis was performed at the incision site. As the right side, the left leg of the graft was guided to the left groin, and an end-to-side anastomosis was performed at the left common femoral artery. Bilateral common iliac artery was occluded just above the bifurcation of the external and internal iliac arteries. Postoperative enhanced computed tomography showed patent extremity arteries and muscle necrosis in the right lower leg.Right foot drop occurred after surgery, but the condition improved over time. The patient was discharged 32 days after surgery.