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Case Reports
. 2018 Mar;97(13):e0212.
doi: 10.1097/MD.0000000000010212.

Saddle embolism treated by thrombolysis and thrombus aspiration via bilateral femoral artery puncture catheter: A case report

Jie Min  1 , Guangqiang Zhang
Affiliations
Case Reports

Saddle embolism treated by thrombolysis and thrombus aspiration via bilateral femoral artery puncture catheter: A case report

Jie Min et al. Medicine (Baltimore). 2018 Mar.

Abstract

Introduction: Abdominal aortic saddle embolism is a rare and severe disease with the manifestation of abrupt onset, rapid progression and high mortality. Endovascular therapy becomes a new option for this disease due to its minor trauma, less complications, no requirement for general anesthesia or abdominal incisions, and shorter hospitalization duration.

Methods: A 50-year-old female was diagnosed as abdominal aortic saddle embolism, and thrombus aspiration was given immediately via bilateral femoral artery puncture catheter along with artery indwelling catheter thrombolysis.

Results: The saddle embolism was removed completely. After 1-month follow-up, the computed tomography angiography (CTA) examination showed neither stenosis nor thrombus in the abdominal aorta and iliac artery. The patient achieved perfect outcome.

Conclusions: Endovascular therapy may be an optional solution for saddle embolism.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
CTA shows thrombus (arrow heads) in the inferior segment of the abdominal aorta and bilateral common iliac artery, left femoral artery and left common iliac artery. (A) coronal maximum intensity projection (MIP). (B and C) volume reconstruction.
Figure 2
Figure 2
(A) Emergency DSA shows thrombus (arrow heads) in the inferior segment of the abdominal aorta and bilateral iliac artery. (B) After 12 hours of thrombolysis, the thrombus presence can be noticed. (C) After 36 hours, the major part of thrombus was dissolved, and the left wall of the abdominal aorta and the left common iliac artery have proximal mural thrombus. (D) Left femoral arterial sheath angiography shows that the embolus in the left abdominal aorta wall is mural thrombus and floating. (E) After aspiration, the thrombus in the aortic and iliac artery completely disappeared. (F) Bilateral lower extremity angiography shows left fibular artery occlusion.
Figure 3
Figure 3
White thrombus and mixed thrombus aspirated by an 8F guiding catheter.
Figure 4
Figure 4
CTA shows no stenosis or thrombus in the abdominal aorta and the iliac artery after 1 month.
See this image and copyright information in PMC

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