One-stage abdominal aortic prosthesis with thrombectomy from the inferior vena cava in a patient with chronic ischemia threatening limb loss

The combination of abdominal aortic occlusion and inferior vena cava thrombosis is quite rare in clinical practice. We present the experience of treating a patient with chronic ischemia threatening limb loss, atherosclerotic occlusion of the infrarenal aorta combined with thrombosis of deep veins of the left lower limb, iliac veins on the left side, thrombus invasion into the inferior vena cava and the presenting 60-mm-flotating segment in it. After hospitalization and examination, a decision was made to perform a one-stage open intervention on the aorta and inferior vena cava. An aorto-femoral bifurcation alloprosthesis with reimplantation of the inferior mesenteric artery into the prosthesis main branche and open thrombectomy from the inferior vena cava were performed successfully. The course of the postoperative period was favorable. The main blood flow in the lower limbs was restored, rest ischemia of the left lower limb was suppressed. The control MSCT-angiography demonstrated that the thrombosis of iliac veins was occlusive, inferior vena cava was without thrombomasses. The patient was discharged in satisfactory condition in 11 days after the operation. The presented clinical case demonstrates high efficiency of the open treatment option in providing care to patients with combined pathology of the aorta and inferior vena cava.