Acute aortic occlusion: A narrative review for emergency clinicians.

Acute aortic occlusion Aorta Emergency medicine Ischemia Vascular

Journal

The American journal of emergency medicine
ISSN: 1532-8171
Titre abrégé: Am J Emerg Med
Pays: United States
ID NLM: 8309942

Informations de publication

Date de publication:
24 Feb 2024
Historique:
received: 18 01 2024
revised: 14 02 2024
accepted: 22 02 2024
medline: 10 3 2024
pubmed: 10 3 2024
entrez: 9 3 2024
Statut: aheadofprint

Résumé

Acute aortic occlusion (AAO) is a rare but serious condition associated with significant morbidity and mortality. This review provides an emergency medicine focused evaluation of AAO, including presentation, assessment, and emergency department (ED) management based on current evidence. AAO refers to obstruction of blood flow through the aorta due to either thrombosis or embolism. This condition primarily affects older adults ages 60-70 with cardiovascular comorbidities and most commonly presents with signs and symptoms of acute limb ischemia, though the gastrointestinal tract, kidneys, and spinal cord may be affected. The first line imaging modality includes computed tomography angiography of the chest, abdomen, and pelvis. ED resuscitative management consists of avoiding extremes of blood pressure or heart rate, maintaining normal oxygen saturation and euvolemic status, anticoagulation with heparin, and pain control. Emergent consultation with the vascular surgery specialist is recommended to establish a plan for restoration of perfusion to ischemic tissues via endovascular or open techniques. High rates of baseline comorbidities present in the affected population as well as ischemic and reperfusion injuries place AAO patients at high risk for complications in an immediate and delayed fashion after surgical management. An understanding of AAO can assist emergency clinicians in diagnosing and managing this rare but devastating disease.

Identifiants

pubmed: 38460466
pii: S0735-6757(24)00093-7
doi: 10.1016/j.ajem.2024.02.033
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

192-197

Informations de copyright

Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing Interest No author has any conflict of interest, and no author has published a prior review on this topic. No AI program was utilized for construction of this review.

Auteurs

Jessica Pelletier (J)

Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA.

Alex Koyfman (A)

Department of Emergency Medicine, UT Southwestern, Dallas, TX, USA.

Brit Long (B)

SAUSHEC, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA. Electronic address: Brit.long@yahoo.com.

Classifications MeSH