Acute aortic occlusion (AAO) is a rare and serious condition where the aorta, the main blood vessel from the heart supplying the lower body, gets blocked. This sudden blockage can be life-threatening and needs immediate medical attention.
What is Acute Aortic Occlusion?
Dr. Ismazizi Zaharudin, a Consultant Vascular Surgeon at Institut Jantung Negara (IJN), explains that AAO occurs suddenly, usually within two weeks. Symptoms that last longer are considered chronic. Recognizing these symptoms early is crucial for effective treatment.
Symptoms and Causes
The main causes of AAO are embolism, where a blood clot travels and blocks the aorta, and thrombosis, where a clot forms in the aorta itself due to plaque buildup. These blockages can happen at the point where the aorta splits into the arteries supplying the legs, known as the aortic bifurcation. Atherosclerosis, the thickening or hardening of arteries due to plaque buildup, is a major risk factor. This can be worsened by high cholesterol, high blood pressure, smoking, diabetes, obesity, and a sedentary lifestyle.
Patients with AAO typically experience sudden severe pain in the lower limbs, paralysis, and changes in skin color, indicating reduced blood flow. The affected limbs may feel cold and appear pale. If untreated, this can lead to gangrene (tissue death), possibly requiring amputation.
Risk Factors and Complications
People with a history of atherosclerosis, blood disorders, or recent major surgery are at higher risk. For embolism, factors like heart valve disease and being female increase the risk. For thrombosis, smoking, diabetes, hypertension, obesity, and sometimes blunt abdominal trauma are significant risk factors.
Complications of AAO can include kidney failure, gastrointestinal issues, and spinal cord damage leading to paralysis. Timely intervention is crucial to prevent severe outcomes, including limb loss and systemic infections.
Prevention and Management
AAO can be treated effectively if detected early. People with high cholesterol, diabetes, hypertension, or other related conditions should be particularly vigilant. Managing stress is also important as it can worsen heart disease risk factors. The mortality rate for AAO varies widely, from 25% to 75%.
Treatment Options
According to Dr. Ismazizi, treatment depends on the underlying cause. Options include embolectomy (removal of the clot), aorta-femoral bypass, and various endovascular techniques aimed at quickly restoring blood flow. Both open and endovascular procedures are available at IJN Vascular Centre. Endovascular procedures, like the Covered Endovascular Reconstruction of Aortic Bifurcation (CERAB), are less invasive but not suitable for all patients. Open surgical procedures, while more invasive, are considered the gold standard despite their higher risks.
The Role of Institut Jantung Negara (IJN)
IJN Vascular Centre boasts a multidisciplinary team dedicated to treating vascular diseases. The team includes vascular surgeons, cardiothoracic surgeons, interventional cardiologists, anesthetists, radiologists, nephrologists, and allied health professionals like nurses and cardiovascular technicians. They collaborate to provide high-quality, evidence-based care for patients with AAO and other vascular conditions.
In summary, AAO is a serious but treatable condition if diagnosed and managed promptly. Understanding the risk factors, symptoms, and treatment options can help in preventing complications and improving outcomes for those affected.