Presentation
Unable to walk with intense pain in the lower legs and numbness in the lower extremities for 10 days.
Patient Data
Severe atherosclerotic disease in the proximal abdominal aorta. Complete occlusion of the abdominal aorta, age indeterminate, below the level of renal arteries. The celiac trunk, superior mesenteric artery, and renal arteries are opacified with contrast. Contrast is visualized in the inferior mesenteric artery, likely through collaterals.
There is complete occlusion of bilateral common iliac, external, and internal iliac arteries, with reconstitution of contrast in the common femoral arteries through collaterals.
More than 50% stenosis in bilateral common femoral arteries. The superficial femoral arteries are patent. Large calcified plaques are visualized in bilateral superficial femoral arteries distally. Contrast is visualized in bilateral popliteal arteries, which are diminutive. Contrast enhancement is visualized in the right leg and anterior-posterior tibialis arteries up to approximately 8 cm above the ankle. On the left side, contrast enhancement is visualized in the anterior and posterior tibialis arteries up to approximately 9 cm above the ankle. No contrast enhancement is visualized in the arteries in bilateral.
Conclusion:
Complete occlusion of the mid-abdominal aorta and bilateral iliac arteries , likely due to atherosclerosis.
Case Discussion
This represents a case of abdominal aortic thrombosis in a patient with a medical history of hypertension, diabetes, and complex regional pain syndrome. An aortic bifemoral bypass was suggested as part of the treatment plan.
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