Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2009

Open Access 01-12-2009 | Case report

Complete abdominal aortic aneurysm thrombosis and obstruction of both common iliac arteries with intrathrombotic pressures demonstrating a continuing risk of rupture: a case report and review of the literature

Authors: Konstantinos A Filis, Emmanuel E Lagoudianakis, Haridimos Markogiannakis, Aikaterini Kotzadimitriou, Nikolaos Koronakis, Konstantinos Bramis, Konstantinos Xiromeritis, Dimitrios Theodorou, Andreas Manouras

Published in: Journal of Medical Case Reports | Issue 1/2009

Login to get access

Abstract

Introduction

Although mural thrombus in an abdominal aortic aneurysm is frequent and its role has been studied extensively, complete thrombosis of an abdominal aneurysm is extremely rare and its natural history in relation to the risk of rupture is not known. The case of a patient with a completely thrombosed infrarenal aneurysm is presented along with a literature review.

Case presentation

We report the case of a 56-year-old Caucasian man with an infrarenal abdominal aortic aneurysm, presenting at our hospital due to critical ischemia of his right lower limb. Computed tomography and angiography demonstrated complete aneurysm thrombosis and obstruction of both common iliac arteries.

Conclusion

During the operation, systolic and mean intrathrombotic pressures, measured in different levels, constituted 74.5-90.2% and 77.5-92.5% of systolic and mean intraluminal pressure and 73-88.4% and 76.5-91.3% of systemic pressure, respectively. Our findings show that there may be a continuing risk of rupture in cases of a thrombosed abdominal aortic aneurysm.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hans SS, Jareunpoon O, Huang R, Hans B, Bove P, Zelenock GB: Relationship of residual intraluminal to intrathrombotic pressure in a closed aneurysmal sac. Vasc Surg. 2003, 37 (5): 949-953. 10.1067/mva.2003.256.CrossRef Hans SS, Jareunpoon O, Huang R, Hans B, Bove P, Zelenock GB: Relationship of residual intraluminal to intrathrombotic pressure in a closed aneurysmal sac. Vasc Surg. 2003, 37 (5): 949-953. 10.1067/mva.2003.256.CrossRef
2.
go back to reference Schurink GW, van Baalen JM, Visser MJ, van Bockel JH: Thrombus within an aortic aneurysm does not reduce pressure on the aneurysmal wall. J Vasc Surg. 2000, 31 (3): 501-506. 10.1016/S0741-5214(00)90311-2.CrossRefPubMed Schurink GW, van Baalen JM, Visser MJ, van Bockel JH: Thrombus within an aortic aneurysm does not reduce pressure on the aneurysmal wall. J Vasc Surg. 2000, 31 (3): 501-506. 10.1016/S0741-5214(00)90311-2.CrossRefPubMed
3.
go back to reference Takagi H, Yoshikawa S, Mizuno Y, Matsuno Y, Umeda Y, Fukumoto Y, Mori Y: Intrathrombotic pressure of a thrombosed abdominal aortic aneurysm. Ann Vasc Surg. 2005, 19 (1): 108-112. 10.1007/s10016-004-0141-3.CrossRefPubMed Takagi H, Yoshikawa S, Mizuno Y, Matsuno Y, Umeda Y, Fukumoto Y, Mori Y: Intrathrombotic pressure of a thrombosed abdominal aortic aneurysm. Ann Vasc Surg. 2005, 19 (1): 108-112. 10.1007/s10016-004-0141-3.CrossRefPubMed
4.
go back to reference Di Martino E, Mantero S, Inzoli F, Melissano G, Astore D, Chiesa R, Fumero R: Biomechanics of abdominal aortic aneurysm in the presence of endoluminal thrombus: experimental characterization and structural static computational analysis. Eur J Vasc Endovasc Surg. 1998, 15 (4): 290-299. 10.1016/S1078-5884(98)80031-2.CrossRefPubMed Di Martino E, Mantero S, Inzoli F, Melissano G, Astore D, Chiesa R, Fumero R: Biomechanics of abdominal aortic aneurysm in the presence of endoluminal thrombus: experimental characterization and structural static computational analysis. Eur J Vasc Endovasc Surg. 1998, 15 (4): 290-299. 10.1016/S1078-5884(98)80031-2.CrossRefPubMed
5.
go back to reference Wang DH, Makaroun MS, Webster MW, Vorp DA: Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J Vasc Surg. 2002, 36 (3): 598-604. 10.1067/mva.2002.126087.CrossRefPubMed Wang DH, Makaroun MS, Webster MW, Vorp DA: Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J Vasc Surg. 2002, 36 (3): 598-604. 10.1067/mva.2002.126087.CrossRefPubMed
6.
go back to reference Satta J, Laara E, Juvonen T: Intraluminal thrombus predicts rupture of an abdominal aortic aneurysm. J Vasc Surg. 1996, 23 (4): 737-739. 10.1016/S0741-5214(96)80062-0.CrossRefPubMed Satta J, Laara E, Juvonen T: Intraluminal thrombus predicts rupture of an abdominal aortic aneurysm. J Vasc Surg. 1996, 23 (4): 737-739. 10.1016/S0741-5214(96)80062-0.CrossRefPubMed
7.
go back to reference Wolf YG, Thomas WS, Brennan FJ, Goff WG, Sise MJ, Bernstein EF: Computed tomography scanning findings associated with rapid expansion of abdominal aortic aneurysms. J Vasc Surg. 1994, 20 (4): 529-535. discussion 535-538CrossRefPubMed Wolf YG, Thomas WS, Brennan FJ, Goff WG, Sise MJ, Bernstein EF: Computed tomography scanning findings associated with rapid expansion of abdominal aortic aneurysms. J Vasc Surg. 1994, 20 (4): 529-535. discussion 535-538CrossRefPubMed
8.
go back to reference Stenbaek J, Kalin B, Swedenborg J: Growth of thrombus may be a better predictor of rupture than diameter in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2000, 20 (5): 466-469. 10.1053/ejvs.2000.1217.CrossRefPubMed Stenbaek J, Kalin B, Swedenborg J: Growth of thrombus may be a better predictor of rupture than diameter in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2000, 20 (5): 466-469. 10.1053/ejvs.2000.1217.CrossRefPubMed
9.
go back to reference Vorp DA, Lee PC, Wang DH, Makaroun MS, Nemoto EM, Ogawa S, Webster MW: Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening. J Vasc Surg. 2001, 34 (2): 291-299. 10.1067/mva.2001.114813.CrossRefPubMed Vorp DA, Lee PC, Wang DH, Makaroun MS, Nemoto EM, Ogawa S, Webster MW: Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening. J Vasc Surg. 2001, 34 (2): 291-299. 10.1067/mva.2001.114813.CrossRefPubMed
10.
go back to reference Kazi M, Thyberg J, Religa P, Roy J, Eriksson P, Hedin U, Swedenborg J: Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall. J Vasc Surg. 2003, 38 (6): 1283-1292. 10.1016/S0741-5214(03)00791-2.CrossRefPubMed Kazi M, Thyberg J, Religa P, Roy J, Eriksson P, Hedin U, Swedenborg J: Influence of intraluminal thrombus on structural and cellular composition of abdominal aortic aneurysm wall. J Vasc Surg. 2003, 38 (6): 1283-1292. 10.1016/S0741-5214(03)00791-2.CrossRefPubMed
11.
go back to reference Ricotta JJ, Kirshner RL: Case report: late rupture of a thrombosed abdominal aortic aneurysm. Surgery. 1984, 95 (6): 753-755.PubMed Ricotta JJ, Kirshner RL: Case report: late rupture of a thrombosed abdominal aortic aneurysm. Surgery. 1984, 95 (6): 753-755.PubMed
12.
go back to reference Dalal S, Donlon M, Beard JD: Thrombosed abdominal aortic aneurysms. Do they need surveillance to prevent late rupture. Eur J Vasc Endovasc Surg. 2001, 22 (6): 570-572. 10.1053/ejvs.2001.1509.CrossRefPubMed Dalal S, Donlon M, Beard JD: Thrombosed abdominal aortic aneurysms. Do they need surveillance to prevent late rupture. Eur J Vasc Endovasc Surg. 2001, 22 (6): 570-572. 10.1053/ejvs.2001.1509.CrossRefPubMed
13.
go back to reference Leke MA, Rowe VL, Hood DB, Katz SG, Kohl RD, Weaver FA: Rupture of a previously thrombosed thoracoabdominal aneurysm. Ann Vasc Surg. 2003, 17 (2): 143-147. 10.1007/s10016-001-0401-4.CrossRefPubMed Leke MA, Rowe VL, Hood DB, Katz SG, Kohl RD, Weaver FA: Rupture of a previously thrombosed thoracoabdominal aneurysm. Ann Vasc Surg. 2003, 17 (2): 143-147. 10.1007/s10016-001-0401-4.CrossRefPubMed
14.
go back to reference Kwaan JH, Dahl RK: Fatal rupture after successful surgical thrombosis of an abdominal aortic aneurysm. Surgery. 1984, 95 (2): 235-237.PubMed Kwaan JH, Dahl RK: Fatal rupture after successful surgical thrombosis of an abdominal aortic aneurysm. Surgery. 1984, 95 (2): 235-237.PubMed
15.
go back to reference Pevec WC, Holcroft JW, Blaisdell FW: Ligation and extraanatomic arterial reconstruction for the treatment of aneurysms of the abdominal aorta. J Vasc Surg. 1994, 20 (4): 629-636.CrossRefPubMed Pevec WC, Holcroft JW, Blaisdell FW: Ligation and extraanatomic arterial reconstruction for the treatment of aneurysms of the abdominal aorta. J Vasc Surg. 1994, 20 (4): 629-636.CrossRefPubMed
Metadata
Title
Complete abdominal aortic aneurysm thrombosis and obstruction of both common iliac arteries with intrathrombotic pressures demonstrating a continuing risk of rupture: a case report and review of the literature
Authors
Konstantinos A Filis
Emmanuel E Lagoudianakis
Haridimos Markogiannakis
Aikaterini Kotzadimitriou
Nikolaos Koronakis
Konstantinos Bramis
Konstantinos Xiromeritis
Dimitrios Theodorou
Andreas Manouras
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2009
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-3-9292

Other articles of this Issue 1/2009

Journal of Medical Case Reports 1/2009 Go to the issue