COMPLEX AORTOILIAC, PELVIC AND VISCERAL REVASCULARIZATION

Authors

  • António Pereira-Neves Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário São João, EPE, Porto, Portugal
  • João Rocha-Neves Department of Biomedicine - Unit of Anatomy, Faculty of Medicine, University of Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário São João, EPE, Porto, Portugal
  • Luís Duarte-Gamas Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário São João, EPE, Porto, Portugal
  • Alfredo Cerqueira Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário São João, EPE, Porto, Portugal
  • Ricardo Gouveia Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Portugal; Department of Angiology and Vascular Surgery, Centro Hospitalar Vila Nova de Gaia/ Espinho, Vila Nova de Gaia, Portugal

DOI:

https://doi.org/10.48729/pjctvs.40

Abstract

Aortoiliac occlusive disease (AIOD) remains an area of debate concerning open and endovascular treatment options. A case of a 63-year old female is reported, with previous known vascular intermittent claudication, that presented in the emergency room with acute ischemia of the right lower limb with 24-hours of evolution. The computer tomographic angiography unveiled occlusion of the superior mesenteric artery, occlusion of left common iliac artery (CIA), subocclusive stenosis of right CIA, occlusion of distal runoffs vessels in the right lower limb and diffuse aorto-iliac disease. The first approach was to place the patient under catheter directed thrombolysis (48h) which led to right pedal pulse recovery but the occlusion of left CIA remained. The patient was then electively submitted to Covered Endovascular Repair of Aortic Bifurcation (CERAB) with chimney to inferior mesenteric artery and with an additional bailout left iliac sandwich due to dissection. Distal pulses are still present after 18 months of follow-up. Endovascular techniques provide a low morbimortality option with similar symptomatic improvement, challenging open surgery as the standard of care even in complex AIOD.

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References

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Published

17-04-2021

How to Cite

1.
Pereira-Neves A, Rocha-Neves J, Duarte-Gamas L, Cerqueira A, Gouveia R. COMPLEX AORTOILIAC, PELVIC AND VISCERAL REVASCULARIZATION. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 17 [cited 2024 Dec. 4];27(3):231-3. Available from: https://pjctvs.com/index.php/journal/article/view/40

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Section

Clinical Cases

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