ACUTE thrombosis of the infrarenal abdominal aorta is a vascular catastrophe rivaling spontaneous rupture as a surgical challenge. Characterized by the sudden onset of bilateral leg pain progressing to numb, cool, paretic extremities, this syndrome is difficult to distinguish from a bifurcation embolus.
Our purpose is to review a group of patients with acute thrombosis, evaluating the problems and results of surgical treatment. Sudden thrombosis of the lower aortic segment appears to be a terminal event associated with severe iliofemoral disease and progressive cardiac failure.
Six patients with acute occlusion of the subrenal aorta have been seen in the past ten years. Five of the six patients with the acute syndrome had a history of peripheral vascular disease dating back several months to years (Fig 1). Preceding the aortic thrombosis, two patients had illiac bypass grafts and one had successive amputations leading to hip disarticulation.1 Two patients