Abstract

Acute aortic occlusion (AAO) is an uncommon but critical vascular emergency high morbidity and mortality. Despite its severity, it remains sparsely documented, primarily through isolated case reports and limited case series. The clinical presentation can vary, making timely diagnosis challenging. Early identification relies heavily on a high index of suspicion and a comprehensive vascular and neurological examination. This case report highlights the case of a patient who arrived at the emergency department with sudden onset paralysis of the lower limbs. Prompt imaging using a computed tomography angiography (CTA) tailored for suspected aortic dissection enabled swift diagnosis of AAO. The patient was immediately treated with anticoagulants followed by surgical thrombectomy. Remarkably, he experienced significant recovery of motor function in his lower extremities. This case underscores the importance of rapid assessment and intervention in suspected AAO to improve functional outcomes and reduce the risk of permanent disability.

• 1.   Babu S.C., Shah P.M., and Nitahara J., Acute aortic occlusion - factors that influence outcome, Journal of Vascular Surgery. (1995) 21, no. 4, 567–575, https://doi.org/10.1016/s07415214(95)70188-5, 2-s2.0-0028921218, 7707562.
• 2.   Battocchio C., Dezi T., D’Andrea A., Taurino M., and Rizzo L., Acute occlusion of descending thoracic aorta, Ann Vasc Surg. (2019) 60, no. 477, https://doi.org/10.1016/j.avsg.2019.03.024, 2-s2.0-85068562671.
• 3.   Tsilimparis N., Hanack U., Pisimisis G., Yousefi S., Wintzer C., and Rückert R.I., Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta - an unusual source of arterial embolism, European Journal of Vascular and Endovascular Surgery. (2011) 41, no. 4, 450–457, https://doi.org/10.1016/j. ejvs.2010.11.004, 2-s2.0-79953035266, 21145267.
• 4.   Grip O., Wanhainen A., and Björck M., Temporal trends and management of acute aortic occlusion: a 21 year experience, European Journal of Vascular and Endovascular Surgery. (2019) 58, no. 5, 690–696, https://doi.org/10.1016/j.ejvs.2019.05.018, 2-s2.085069665118.
• 5.   Baeza C., González A., Torres P., Pizzamiglio M., Arribas A., and Aparicio C., Acute aortic thrombosis in COVID-19, Journal of Vascular Surgery Cases and Innovative Techniques. (2020) 6, no. 3, 483–486, https://doi.org/10.1016/j. jvscit.2020.06.013, 32838094.
• 6.   Crawford J.D., Perrone K.H., Wong V.W., Mitchell E. L., Azarbal A.F., Liem T.K., Landry G.J., and Moneta G.L., A modern series of acute aortic occlusion, Journal of Vascular Surgery. (2014) 59, no. 4, 1044–1050, https:// doi.org/10.1016/j.jvs.2013.10.080, 2-s2.084897044646, 24393282.
• 7.   Wong S.S., Roche-Nagle G., and Oreopoulos G., Acute thrombosis of an abdominal aortic aneurysm presenting as cauda equina syndrome, Journal of Vascular Surgery. (2013) 57, no. 1, 218–220, https://doi.org/10.1016/j. jvs.2012.06.092, 2-s2.0-84871619871, 23063443.
• 8.   Azzarone M., De Troia A., Iazzolino L., Nabulsi B., and Tecchio T., Hybrid treatment of acute abdominal aortic thrombosis presenting with paraplegia, Ann Vasc Surg. (2016) 33, no. 228, https://doi.org/10.1016/j.avsg.2015.10.041, 2-s2.0-84962082138.

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