PMC8612803_01
CTA before operation ((a) and (c)) after the operation ((b) and (d)). The red arrow points to the location of the lesion before and after the operation.
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They were found to have "continuity interruption" at the end of the abdominal aorta, and irregular stenosis of the local lumen of the bilateral femoral artery, deep femoral artery, popliteal artery, left anterior and posterior tibial artery, and peroneal artery was observed (Figures 1(a) and 1(c)). Reexamination of CTA revealed that the abdominal aorta, bilateral common iliac, internal and external iliac arteries, bilateral femoral arteries, deep femoral arteries, and popliteal arteries were functioning well (Figures 1(b) and 1(d)).
The first DSA image. Occlusion of the right iliac artery and multiple thromboses in the wall (a). Occlusion of the abdominal aorta at the level of the right renal artery (b).
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Digital subtraction angiography (DSA) revealed that the right iliac artery was occluded, multiple thrombi were attached to the wall, and the abdominal aorta was occluded from the right renal artery level (Figure 2).
The second DSA image. Thrombolysis catheter blockage, partial development of right external iliac artery (a). Thrombolysis in the proximal renal abdominal aorta (b). Replacement of thrombolytic catheter angiography (c).
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Replacement of 5F 20 cm UNIFUSE thrombolysis catheter continued thrombolysis for 24 hours (Figure 3).
The third DSA image. Angiography before and after thrombectomy ((a) and (b)). Angiography before and after balloon dilatation ((c) and (d)).
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The angiography of the right femoral artery showed a large filling defect below the opening of the renal artery of the abdominal aorta, the development of the right iliac artery was unobstructed, and the left iliac artery was not seen (Figure 4(a)). The 14 mm balloon was placed above the renal artery, and the balloon was filled and pulled to the end of the abdominal aorta to move the filling defect downward (Figure 4(b)). The stenotic segments of bilateral iliac arteries were dilated with 8 mm balloon, and the angiographic results showed improved blood flow than before (Figures 4(c) and 4(d)).
Angiography of right popliteal artery before and after thrombectomy ((a) and (b)).
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The angiography showed that the blood flow of the right popliteal artery was smooth (Figure 5).