Early Detection of Thromboembolism during Open Repair for Complex Aortoiliac Aneurysms Using Continuous Noninvasive Lower Limb Oximetry.

Abstract

A 71-year-old man was referred to our department for open surgery for complex aortoiliac aneurysms. Computed tomography angiography demonstrated aneurysms of the abdominal aorta, bilateral common iliac arteries, and the left internal iliac artery. After stent graft placement in bilateral internal iliac arteries, we planned open surgery. Before cross-clamping the aorta, regional saturation of oxygenation in the left lower limb suddenly decreased from approximately 60% to 30%, despite being stable in the right lower limb. Intraoperative angiography revealed occlusion at the popliteal artery level, for which thromboembolectomy was successfully performed. After that, the aortoiliac aneurysms were replaced. The postoperative course was uneventful.