A Case Series of Completely Thrombosed Abdominal Aortic Aneurysms

Background: Completely thrombosed AAA (th-AAA) has been infrequently described in the literature. The present study evaluated the incidence and report the outcomes of open surgical repair (OSR) of a clinical series of th-AAAs. Methods: This is a single-center, observational cohort study of consecutive th-AAAs identified between 10 October 1998, and 31 January 2024. Open repair was carried out through a transperitoneal route, and Dacron knitted graft replacement. Follow-up included the clinical visit and duplex ultrasound at 30 days, and annually thereafter. The primary outcome was overall survival. The secondary outcome was the freedom from aorta-related reintervention. Results: Out of 2237 AAA repairs, we identified 16 (0.7%) th-AAAs. They were all men with a mean age of 74 years ± 8 (range, 54–89). The median of aneurysm diameter was 49 mm (IQR, 46–52). Rupture was the presenting scenario in four (25%) patients. Early mortality and major amputation did not occur. At a mean follow-up of 70 months ± 48 (range, 11–192), the freedom from aorta-related mortality was 100%, and graft-related complications were not observed. Conclusions: The incidence of th-AAA was <1%. Although rupture was the presenting scenario in nearly 25% of the cases, OSR was safe and effective due to the absence of aorta-related mortality and the long-term durability of the repair.