Lisette van Dam

Chapter 9 146 ABSTRACT A 43-year-old man with abdominal angina for several months showed a large suprarenal aneurysm with extensive circumferential wall thrombosis of the abdominal aorta on CT angiography, with complete occlusion of the right renal artery and critically stenosed left renal artery. He suffered from severe hypertension and renal failure. A percutaneous transluminal angioplasty (PTA) was planned. After complicated PTA leading to occlusion of the left renal artery, successful rescue revascularization surgery was performed. Hesitant to start anticoagulant treatment because of a high bleeding risk, magnetic direct thrombus imaging (MRDTI) to assess the age of the extensive arterial thrombosis was done. The MRDTI scan showed a low signal intensity of the aortic thrombus indicative of chronic thrombosis rather than acute thrombosis. Oral anticoagulant treatment was therefore not started. The patient recovered without major complications.