Prolonged Thrombolysis Followed by Double Balloon Angioplasty for an Abdominal Aortic Occlusion

Abstract

A 69-year-old woman was admitted with clinical symptoms of an acute abdominal aortic occlusion. Femoral and distal pulses were absent with lower extremity paralysis and loss of sensation. Digital subtraction angiogram confirmed the infrarenal abdominal aortic occlusion. A selective urokinase infusion was initiated from a left brachial approach and continued in conjunction with heparin therapy for 48 hours. Clinical improvement was noted in 24 hours. By 48 hours there was complete abdominal aorta thrombolysis with angiograms revealing bilateral common iliac stenosis. The percutaneous intervention was completed from a brachial approach utilizing conventional (5 French) balloon angioplasty catheters using a double wire “kissing” balloon technique. Following angioplasty, distal pulses were present; the angiograms confirmed patent vessels with excellent distal flow. (J Interven Cardiol 1991; 5:25–27)