Korean J Med.  2013 Sep;85(3):302-307. 10.3904/kjm.2013.85.3.302.

Complete Revascularization of Juxtarenal Aortic Occlusion by Endovascular Treatment and Adjunctive Anticoagulation

• Kim GW
• Moon JY
• Jin SM
• Moon JH
• Kim KH
• Kim SH
• Lim SW

• KMID: 1722642
• DOI: http://doi.org/10.3904/kjm.2013.85.3.302

Abstract

Chronic atherosclerotic occlusion of the abdominal aorta is a rare disease in clinical practice. In this disease, juxtarenal aortic occlusion is defined as the condition extended, adjacent to the renal arteries. The treatment of juxtarenal aortic occlusion is more difficult than a 'simple' abdominal aortic occlusion. Vascular surgery of a juxtarenal aortic occlusion-specifically aortic endarterectomy and bypass grafting-is a challenging procedure that almost invariably requires aortic cross-clamping above the level of the renal arteries, and may be associated with significant morbidity and mortality. With the advent of endovascular treatment, percutaneous transluminal angioplasty and stent implantation have been used increasingly as an alternative to conventional surgery in the management of patients with aortoiliac disease. However, endovascular treatment for juxtarenal aortic occlusion is not common and, also, special attention is needed with regard to possible renal complications. Here, we report the successful revascularization of a case of chronic juxtarenal aortic occlusion with endovascular treatment and adjunctive anticoagulation.

Keyword

Leriche's syndrome; Abdominal aorta; Juxtarenal aortic occlusion; Endovascular procedure

MeSH Terms

Angioplasty
Aorta, Abdominal
Endarterectomy
Endovascular Procedures
Humans
Leriche Syndrome
Rare Diseases
Renal Artery
Stents