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

Gun Woo Kim, Jae-Youn Moon, Sun Mi Jin, Jie Hye Moon, Kyung Ho Kim, Sang-Hoon Kim, Sang-Wook Lim
2013 Korean Journal of Medicine  
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
more » ... ping 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. ( Korean J Med 2013;85:302-307) 서 론 과거의 부검을 통한 연구에 따르면 대동맥 말단부위를 포 함한 복부대동맥 완전폐쇄(total occlusion of infrarenal aorta) 는 0.15%의 빈도로 드물게 나타나는 질환으로 알려졌다[1]. Bergan과 Trippel [2]은 이러한 폐쇄성 복부 대동맥 질환 중 에서 폐쇄가 점차 근위부로 진행하여 신동맥 기시부까지 파 급된 질환을 신동맥 근접 대동맥 폐색증(juxtarenal aortic
doi:10.3904/kjm.2013.85.3.302 fatcat:2fjypkgczjf5ddipdvoabrazb4