Acute Ischemic Polyneuropathy after Acute Abdominal Aortic Occlusion: A case report

ABSTRACT

A 45-year-old man with a long history of nephrotic syndrome presented with low back pain and progressive weakness of both legs for one day. Physical examination showed an acutely ill-appearing patient with a loss of both femoral artery pulses. Immediate digital subtraction angiography of abdominal aorta revealed total occlusion of the distal abdominal aorta. Transvascular embolectomy using urokinase was undertaken 6 hours later. Digital subtraction angiography after embolectomy revealed both common ilicac arteries to be patent with good distal flow. Electrodiagnostic examinations (post embolectomy 5th and 45th day) revealed peripheral polyneuropathy of both lower extremity. Anticoagulation therapy was continued and the patient was discharged several months later. During this period, there was improvement in both lower limbs from power of grade 1 to 4 except for both ankle dorsiflexors which had not recovered. We report a rare case of peripheral ischemic polyneuropathy of both lower extremities as the result of acute abdominal aortic occlusion.