In-hospital outcomes of acute aortic occlusion treated by endovascular intervention: A single center study.

Background: Endovascular intervention by means of thrombolysis is emerging as a promising management of Acute Aortic Occlusion (AAO). This study aims to evaluate the outcomes of endovascular thrombectomy for AAO cases in a single-center tertiary hospital in Indonesia.

Methods: We review retrospectively AAO patients treated by Rheolytic thrombectomy ± stenting or TEVAR at our referral center from 2011 to 2024. Clinical characteristics and outcomes were analyzed independently and in correlation to one another.

Result: Out of 21 episodes in 19 patients, AAO was correlated with thromboembolism in 57.1 %, in situ thrombosis in 23.8%, and malperfusion syndrome in 19% of patients. Most prevalent comorbidities found were coronary arterial disease, hypertension, heart failure, and atrial fibrillation. Method of revascularization were Rheolytic thrombectomy (12), covered stent (5), catheter-directed thrombolysis (2), and TEVAR (4) with an average 90.9% success rate. In-hospital mortality was 21% and did not vary significantly according to etiology (thromboembolism 30% vs in situ thrombosis 20%) except for malperfusion syndrome 0% which comprised of four patients. All fatality occurred among patients with history of coronary artery disease and one failed revascularization case required urgent amputation (5.3%). Average length of stay was 8.67 ± 5.31 days.

Conclusion: Based on our data, thromboembolism remained highly associated with occurrence of AAO. Endovascular approach by Rheolytic thrombectomy is proven to be comparable or slightly superior in restoring occluded aorto-iliac connection compared to conventional management options. Compared to previous studies, this study establishes a wider representation of AAO cases treated by endovascular means considering the rarity of cases.