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. 2025 Mar 11;12(3):98.
doi: 10.3390/jcdd12030098.

A Case Series of Completely Thrombosed Abdominal Aortic Aneurysms

Raffaello Bellosta  1 , Giulia Anna Sala  2 , Marco Franchin  2   3 , Luca Luzzani  1 , Alessandro Pucci  1 , Gabriele Piffaretti  2 , Maria Cristina Cervarolo  2   3
Affiliations

A Case Series of Completely Thrombosed Abdominal Aortic Aneurysms

Raffaello Bellosta et al. J Cardiovasc Dev Dis. .

Abstract

Background: Completely thrombosed AAA (th-AAA) has been infrequently described in the literature. The present study evaluated the incidence and report the outcomes of open surgical repair (OSR) of a clinical series of th-AAAs.

Methods: This is a single-center, observational cohort study of consecutive th-AAAs identified between 10 October 1998, and 31 January 2024. Open repair was carried out through a transperitoneal route, and Dacron knitted graft replacement. Follow-up included the clinical visit and duplex ultrasound at 30 days, and annually thereafter. The primary outcome was overall survival. The secondary outcome was the freedom from aorta-related reintervention.

Results: Out of 2237 AAA repairs, we identified 16 (0.7%) th-AAAs. They were all men with a mean age of 74 years ± 8 (range, 54-89). The median of aneurysm diameter was 49 mm (IQR, 46-52). Rupture was the presenting scenario in four (25%) patients. Early mortality and major amputation did not occur. At a mean follow-up of 70 months ± 48 (range, 11-192), the freedom from aorta-related mortality was 100%, and graft-related complications were not observed.

Conclusions: The incidence of th-AAA was <1%. Although rupture was the presenting scenario in nearly 25% of the cases, OSR was safe and effective due to the absence of aorta-related mortality and the long-term durability of the repair.

Keywords: abdominal aortic aneurysm; acute thrombosis; thrombosed abdominal aortic aneurysm.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consort diagram of open surgical aortic repair for thrombosed abdominal aortic aneurysm (1998 to 2024, n = 16).
Figure 2
Figure 2
Preoperative computed tomography angiography (A,B) showing the infrarenal abdominal aortic aneurysm rupture into the left psoas muscle (asterisk). Volume rendering 3D reconstruction highlighted the site of rupture ((C), white arrow). Intraoperative finding (D) the final reconstruction after aortic graft replacement using a bifurcated graft with the inferior mesenteric artery transposition (asterisk). Follow-up computed tomography angiography at 48 months follow-up confirmed the absence of graft-related complication and the patency of the adjunctive above-the-knee femoro-popliteal reconstruction ((E), white arrow).
Figure 3
Figure 3
Summary of the recent literature dealing with thrombosed abdominal aortic aneurysm. (n, number; M, Male; F, Female; AAA, abdominal aortic aneurysm; ALLI, acute lower limb ischemia; CLTI, critical limb threatening ischemia; n.r., not reported; EVAR; endovascular aortic repair) [2,3,4,9,10,11,12,13,14,15,16,17,18,19,20,21,22].
See this image and copyright information in PMC

References

    1. Anjum A., von Allmen R., Greenhalgh R., Powell J.T. Explaining the decrease in mortality from abdominal aortic aneurysm rupture. Br. J. Surg. 2012;99:637–645. doi: 10.1002/bjs.8698. - DOI - PubMed
    1. Li H.L., Chan Y.C., Cui D.Z., Cheng S.W. Acute Thrombosis of an Infrarenal Abdominal Aortic Aneurysm Presenting as Bilateral Critical Lower Limb Ischemia. Vasc. Endovasc. Surg. 2021;55:186–188. doi: 10.1177/1538574420954297. - DOI - PubMed
    1. Robaldo A., Apostolou D., Persi F., Peano E., Maione M. EVAR Solution For Acutely Thrombosed Abdominal Aortic Aneurysm in a Patient with COVID-19. EJVES Vasc. Forum. 2022;54:41–43. doi: 10.1016/j.ejvsvf.2022.01.006. - DOI - PMC - PubMed
    1. Wu C.Y., Rectenwald J.E. Incidental discovery of a chronically thrombosed abdominal aortic aneurysm: Case report and literature review. Ann. Vasc. Surg. 2015;29:1018.e1–1018.e4. doi: 10.1016/j.avsg.2015.01.004. - DOI - PubMed
    1. Chaikof E.L., Dalman R.L., Eskandari M.K., Jackson B.M., Lee W.A., Mansour M.A., Mastracci T.M., Mell M., Murad M.H., Nguyen L.L., et al. The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. J. Vasc. Surg. 2018;67:2–77.e2. doi: 10.1016/j.jvs.2017.10.044. - DOI - PubMed

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