Total occlusive thrombosis of the abdominal aorta following holmium laser lithotripsy and ureteroscopy
Abstract
Abdominal aortic thrombosis (AAT) is a rare condition with substantial morbidity and mortality risk if not treated promptly. AAT typically occurs in postoperative patients, particularly those with certain risk factors. Here, we present the case of a urology patient who underwent ureteroscopy and laser lithotripsy for ureterolithiasis. During the postoperative period, the patient was re-admitted with a massive intra-abdominal arterial thrombosis involving the iliac and renal arteries and abdominal aorta. Emergency thrombectomy, angioplasty, and catheter-directed thrombolysis were performed in multiple stages. After a complex postoperative course in the intensive care unit, the patient survived and was discharged in stable condition.
##plugins.themes.bootstrap3.article.details##
abdominal aortic thrombosis, occlusive thrombosis, abdominal aorta, laser lithotripsy
2. De Coninck V, Keller EX, Somani B, et al. Complications of ureteroscopy: a complete overview. World J Urol. 2020 Sep;38(9):2147-2166. doi: 10.1007/s00345-019-03012-1. PMID: 31748953.
3. Grasso M, Bagley D. Small diameter, actively deflectable, flexible ureteropyeloscopy. J Urol. 1998 Nov;160(5):1648-53; discussion 1653-4. PMID: 9783924.
4. Violette PD, Cartwright R, Briel M, Tikkinen KA, Guyatt GH. Guideline of guidelines: thromboprophylaxis for urological surgery. BJU Int. 2016 Sep;118(3):351-8. doi: 10.1111/bju.13496. PMID: 27037846.
5. Bi Y, Chen H, Zhang W, Ren J, Han X. Treatment of aortic thrombosis with retrievable stent filter and thrombolysis: a case report. BMC Cardiovasc Disord. 2019 Mar 5;19(1):54. doi: 10.1186/s12872-019-1037-z. PMID: 30836958; PMCID: PMC6402280.
6. Refinetti P, Legay L, Fontaine JP, Peyrony O. Abdominal aortic occlusion due to acute thrombosis. Intern Emerg Med. 2019 Sep;14(6):1003-1004. doi: 10.1007/s11739-019-02102-7. PMID: 31079271.
7. Carneiro GJP, Martins C. Total occlusion of abdominal aorta: still a deadly event in the very elderly. Arch Clin Cases. 2021 Dec 29;8(3):42-45. doi: 10.22551/2021.32.0803.10184. PMID: 34984224; PMCID: PMC8717000.
8. Yamase Y, Kuwabara F, Watanabe K, et al. A case of floating thrombus in the ascending aorta that caused recurrent peripheral arterial embolic events. J Cardiol Cases. 2015 May 21;12(2):57-60. doi: 10.1016/j.jccase.2015.04.009. PMID: 30546565; PMCID: PMC6262140.
9. Arima T, Muroya K, Kawamoto K, Koba Y, Omura T. Aortic Thrombosis in a Patient With Malignant Disease: A Literature Review and Case Presentation. Vasc Endovascular Surg. 2019 Feb;53(2):139-144. doi: 10.1177/1538574418813623. PMID: 30466376.
10. Ostertag-Hill CA, Titus JM, Skeik N. A Unique Case of Aortic Thrombosis With Elevated Lipoprotein(a). Vasc Endovascular Surg. 2016 May;50(4):286-9. doi: 10.1177/1538574416642875. PMID: 27075991.
11. Elyamany G, Alzahrani AM, Bukhary E. Cancer-associated thrombosis: an overview. Clin Med Insights Oncol. 2014 Dec 4;8:129-37. doi: 10.4137/CMO.S18991. PMID: 25520567; PMCID: PMC4259501.
12. Raso S, Napolitano M, Saccullo G, Siragusa S. Abdominal aortic thrombosis secondary to reactive thrombocytosis in a patient with iron deficiency anemia. Ann Hematol. 2016 Aug;95(8):1389-90. doi: 10.1007/s00277-016-2715-x. PMID: 27256347.
13. Marasco G, Scaioli E, Zagari RM, Belluzzi A. Aortic thrombosis recurrence in a Crohn's disease patient. Acta Gastroenterol Belg. 2018 Oct-Dec;81(4):546. PMID: 30645932.
14. Labidi J, Selmi Y, Ariba YB, Elloumi Z, Othmani S. A case of abdominal aortic thrombosis associated with the nephrotic syndrome. Saudi J Kidney Dis Transpl. 2017 Jan-Feb;28(1):174-177. doi: 10.4103/1319-2442.198246. PMID: 28098122.
15. Kerenick D, Clore J, Jakubowski J. Spontaneous Thrombosis of the Aortic Arch after Outpatient Urologic Procedure. Clin Pract Cases Emerg Med. 2018 Aug 15;2(4):312-315. doi: 10.5811/cpcem.2018.7.38796. PMID: 30443614; PMCID: PMC6230363.
16. Deng XX, Zhang W, Fu D, Fu B. Renal Pseudoaneurysms after Flexible Ureteroscopy and Holmium Laser Lithotripsy: A Case Report. Front Surg. 2022 May 12;9:896548. doi: 10.3389/fsurg.2022.896548. PMID: 36034371; PMCID: PMC9406514.
17. Kupczynska D, Barc P, Antkiewicz M, Szyber P. 77-year-old woman with free-floating thrombus in abdominal aorta, causing acute renal dysfunction. Acta Angiologica, 2017; 23: 135-8. doi: 10.5603/AA.2017.0012
18. Mungun-Ulzii K, Erdenekhuu N, Altantsetseg P, Zulgerel D, Huang SL. Asymptomatic Mongolian middle-aged women with high homocysteine blood level and atherosclerotic disease. Heart Vessels. 2010 Jan;25(1):7-13. doi: 10.1007/s00380-009-1156-z. PMID: 20091392.
19. Kadoya Y, Zen K, Oda Y, Matoba S. Successful Endovascular Treatment for Aortic Thrombosis Due to Primary Antiphospholipid Syndrome: A Case Report and Literature Review. Vasc Endovascular Surg. 2019 Jan;53(1):51-57. doi: 10.1177/1538574418791355. PMID: 30092725.
20. Meyermann K, Trani J, Caputo FJ, Lombardi JV. Descending thoracic aortic mural thrombus presentation and treatment strategies. J Vasc Surg. 2017 Sep;66(3):931-936. doi: 10.1016/j.jvs.2017.05.109. PMID: 28754361.
21. Fang L, Lai Z, Qiu C, et al. Endovascular Treatment for Infrarenal Aortic Occlusion: A Systematic Review and Meta-Analysis. Ann Vasc Surg. 2020 Jan;62:432-441.e13. doi: 10.1016/j.avsg.2019.05.034. PMID: 31415817.
22. Xiang L, Zhou H, Jiang Z, Pan J, Yang M. Abdominal aortic thrombosis associated with nephrotic syndrome. Am J Med Sci. 2014 Jan;347(1):91-2. doi: 10.1097/MAJ.0000000000000208. PMID: 24309289.

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Archive of Clinical Cases is protected by copyright and may be used in accordance with copyright and other applicable laws. Content available at www.clinicalcases.eu and our digital applications is intended for personal noncommercial use.
Authors who submit a manuscript for publication in Archive of Clinical Cases agree to the following terms: a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) only after the final version of the manuscript was accepted and published, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). d. It is compulsory that before submission authors ensure that their work was not published in any other medical journals or pending acceptance for publication and that "Archives of Clinical Cases" is the only beneficiary at that moment if their work/case will be accepted by us.
Guidelines for linking to www.clinicalcases.eu a. The main purpose of the site linking to the Archive of Clinical Casess site should be educational. b. Links should be made to the Archive of Clinical Casess home page (www.clinicalcases.eu) or to the articles abstract. c. It is forbidden to use the Archive of Clinical Casess cover by outside organizations unless permission has been granted in advance, notifying our Secretary. d. Material owned by the Archive of Clinical Cases (including the name, logo, cover, and text) may not be used in any manner that may induce the idea or suggest that the Archive of Clinical Cases is in some way recommending a specific company, product or service. e. You must not use or allow others to access or use, all or any part of our Site or the contents and/or applications on it for commercial purposes without our permission. To seek permission to do anything prohibited by or not contained in these TERMS, or which requires our prior consent or agreement, you can contact us.
https://orcid.org/0000-0003-0822-3084