Acute limb ischemia (ALI) attributable to mural thrombus in an abdominal aortic aneurysm (AAA) is a clinically relevant complication owing to its high mortality risk. We encountered a patient with a floating thrombus in an AAA, which caused ALI. Computed tomography revealed an AAA with irregular mural thrombi, along with left popliteal artery occlusion. We performed urgent thrombectomy followed by elective endovascular aneurysm repair without any major complications. The keys to this successful outcome were earlier extremity reperfusion and less invasive aortic repair.
Kojima et al. (Thu,) studied this question.