Interruption of the abdominal aorta can be a viable, albeit rare, surgical option for ruptured abdominal aortic aneurysm in patients with severe pre-existing lower extremity arterial occlusive disease and amputations.
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May support aortic interruption in select ruptured AAA with prior amputations; hypothesis-generating and should not change practice.
A case of ruptured abdominal aortic aneurysm treated by interruption of the abdominal aorta is reportod.A 58-year-old man complained of severe abdominal and back pain and pulsatile abdominal tumor. His lower extremities had been amputated bilaterally at the age of 29 years, because of thromboangitis obliterans. Preoperative enhanced CT confirmed reptured abdominal aortic aneurysm.On surgery, a large aneurysm located between the renal arteries and aortic bifurcation, penetrating into the retroperitoneal cavity. In addition, bilateral external iliac and left internal iliac arteries were occluded. Therefore, the abdominal aorta was transected and closed just below the renal arteries, and the right internal iliac artery was ligated. In spite of the acute interruption of the blood flow to lower extremities, the patient recovered completely after the operation.This type of operation for adbominal aortic aneurysm is very rare only available to patients with severe arteriosclerosis obliterans and/or thromboangitis obliterans in their lower extremities.
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Anzai et al. (1986) studied this question.
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