CHRONIC OCCLUSION OF THE BIFURCATION OF THE AORTA

OCCLUSION of the terminal aorta may occur suddenly as a result of a saddle embolus or may occur gradually as a result of progressive thrombosis. Acute embolic occlusion is more frequent 1 and more dramatic than is gradual thrombotic occlusion and its diagnosis more easily made. The insidious nature of occlusion by thrombosis and the unawareness of many clinicians that the aortic bifurcation may be completely obstructed without death or rapid gangrene of the lower extremities have prevented the recognition of many cases. Unfortunately, the patients, like those with other chronic occlusive arterial diseases, may live for months or years in suffering and disability. Recent articles by Leriche and Morel 2 and Elkin and Cooper 3 have pointed out that this syndrome has a fairly typical chain of signs and symptoms, and, if kept in mind, the diagnosis is not difficult. INCIDENCE The infrequency of thrombotic occlusion of the aorta is