Treatment Outcomes and Risk Factors for In-Hospital Mortality in Patients with
Acute Aortic Occlusion
#MMPMID29984213
Na DH
; Hwang D
; Park S
; Kim HK
; Huh S
Vasc Specialist Int
2018[Jun]; 34
(2
): 19-25
PMID29984213
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PURPOSE: The aims of the present study are to determine the outcomes after acute
aortic occlusion (AAO) and analyze the risk factors for in-hospital mortality.
MATERIALS AND METHODS: We retrospectively analyzed 24 patients who were diagnosed
with AAO from 2002 to 2017 in our registered data. Demographic and radiologic
characteristics of AAOs were retrospectively collected. Perioperative treatment
outcomes including in-hospital mortality were also assessed and the risk factors
of in-hospital mortality were analyzed. RESULTS: The median symptom duration was
21 hours. Five patients had complete paraplegia and 10 patients (41.7%) were
initially evaluated for central nervous system disorders instead of acute
arterial occlusion. The etiology was determined to be aortoiliac thrombosis in 17
patients (70.8%) and embolic occlusion in 7. Surgical revascularization was
performed in 23 patients, and one patient did not receive any treatment. The
overall in-hospital mortality was 34.8% (8/23) and 30-day mortality was 26.1%. In
the univariate analysis, age (P=0.040), preoperative renal insufficiency (serum
creatinine over 1.5 mg/dL at the time of presentation) (P=0.008), postoperative
acute kidney injury (need for dialysis or an increase in serum creatinine of
>50.0% within 48 hours) (P=0.006), combined external iliac artery occlusion
(P=0.019) and combined bilateral internal iliac artery occlusion (P=0.039) were
associated with in-hospital mortality. CONCLUSION: A substantial number of AAO
patients were initially evaluated for a central nervous system lesion, which led
to a delay in diagnosis. Thus, vascular examinations should always be performed
in every patient presenting with lower limb neurologic deficits. Age,
perioperative renal function, and combined iliac artery occlusion were associated
with the prognosis of AAOs.
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