Review ArticlesAcute Aortic Occlusion and Its Sequelae Metabolic, Pathologic Etiology, and ManagementHines, George L. MD; Liu, Helen H. DOAuthor Information From the Division of Vascular Surgery, New York University/Winthrop Hospital, Mineola, NY. Disclosure: The authors have no conflicts of interest to report. Correspondence: George L. Hines, MD, Division of Vascular Surgery, NYU Winthrop Vascular Surgery, 200 Old Country Road, Suite 120, Mineola, NY 11501. E-mail: [email protected] Cardiology in Review: March/April 2021 - Volume 29 - Issue 2 - p 57-61 doi: 10.1097/CRD.0000000000000313 Buy Metrics Abstract Acute occlusion of the abdominal aorta is a catastrophic occurrence that results in high risk of limb loss and death. The etiology has historically been either acute embolism obstructing the aortic bifurcation in 8% to 75% of patients, or thrombosis of existing aorta-iliac occlusive disease in 35% to 84% of patients. Other etiologies include thrombosis of either a previously placed endograft or aortic graft or acute dissection. The most common symptoms are severe pain in almost 100% of patients or lower extremity paralysis/paresis in up to 80% of patients. Evaluation in the past was by angiography, but presently, computed tomography angiography is the preferred imaging study. Treatment is dependent on the etiology and includes embolectomy, aorta femoral bypass, axillary femoral bypass, and endovascular techniques. The aim of intervention is to restore flow in the shortest time period. Mortality rates vary widely from 17% to 52%, amputation occurs in up to 30% of patients. Paraplegia can occur in 40% of patients, renal insufficiency in 40% to 70%, and visceral ischemia in 6% to 14%. Both mortality and morbidity are affected by the duration of ischemia and the local and systemic complications of reperfusion injury. Complications of acute aortic occlusion can be reduced by a more prompt diagnosis, rapid intervention, and a more rapid and complete reestablishment of perfusion. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.