Tawfiq Almezeiny https://orcid.org/0000-0003-0822-3084

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.

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Keywords

abdominal aortic thrombosis, occlusive thrombosis, abdominal aorta, laser lithotripsy

References
1. Rice KR, Brassell SA, McLeod DG. Venous thromboembolism in urologic surgery: prophylaxis, diagnosis, and treatment. Rev Urol. 2010 Spring;12(2-3):e111-24. PMID: 20811548; PMCID: PMC2931288.
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.
How to Cite
Almezeiny, T. (2026). Total occlusive thrombosis of the abdominal aorta following holmium laser lithotripsy and ureteroscopy. Archive of Clinical Cases, 13(1), 14-18. https://doi.org/10.22551/2026.50.1301.10335
Section
Case Reports

How to Cite

Almezeiny, T. (2026). Total occlusive thrombosis of the abdominal aorta following holmium laser lithotripsy and ureteroscopy. Archive of Clinical Cases, 13(1), 14-18. https://doi.org/10.22551/2026.50.1301.10335