DD: Aortic occlusion

• Aortic embolism

  • Referred to as a saddle embolus when located at the aortic bifurcation

  • Commonly caused by cardiac emboli

    • Myocardial infarction

    • Atrial fibrillation

    • Rheumatic heart disease

• Thrombosis of atherosclerotic aorta

• Stent or graft occlusion

• Aortic dissection

The clinical features of acute aortic occlusion are due to ischemia of the tissues distal to the level of occlusion.

• Occlusion at aortic bifurcation: bilateral acute limb ischemia (most common presentation)

  • Limb pain

  • Pallor or cyanosis

  • Absent pulse

  • Paresthesia and paralysis

• Occlusion above aortic bifurcation

  • Bilateral acute limb ischemia

  • Acute abdomen

  • Acute renal failure

• CT angiography (confirmatory test)

• Investigate the underlying cause

  • ECG

  • Echocardiography

• Bilateral transfemoral embolectomy

• Aortobifemoral bypass

• Thrombolysis