Treatment of Aortoiliac Embolism in Acute Aortic Occlusion with Bilateral Lower Limb Ischaemia
Acute aortic occlusion — classically presenting as a saddle embolus lodging at the aortic bifurcation — is a vascular emergency that produces simultaneous ischaemia of both lower limbs. Prompt recognition and an immediate treatment decision are essential.
Clinical scenario
Acute aortic occlusion (e.g. saddle embolus) with bilateral lower limb ischaemia. Guidelines recommend that revascularisation is performed urgently in this setting.
Treatment approach
Management is centred on urgent revascularisation. Several surgical and catheter-based strategies exist — the full structured protocol outlines the specific options, the selection criteria that guide the choice between them, and any associated considerations.
Complete regimen details, sequencing, and individualised decision support are available in the full protocol.
References
DOI: 10.1016/j.ejvs.2019.09.006
For patients with acute limb ischaemia secondary to acute aortic occlusion, it is recommended that revascularisation is performed urgently.
In the Swedish study, 32% underwent thrombo-embolectomy, 22% CDT, 19% axillobifemoral bypass, and 18% aortobi-iliac or -bifemoral bypass.
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