Suprarenal aortic occlusion.

Proximal propagation of an occlusive distal aortic thrombus to the suprarenal level is rare, probably resulting from diminished renal blood flow, and is invariably accompanied by renal failure. Three similar cases of total suprarenal aortic occlusion with renal failure are presented. In each, one kidney was significantly smaller than the other, probably caused by long-standing disease. The combination of bilaterally absent or markedly decreased femoral pulses with diminished renal function or a unilateral small kidney should therefore be considered dangerous. To prevent proximal propagation of thrombosis and death from renal failure, such patients should undergo arteriography and surgical repair promptly even though their clinical symptoms might be relatively mild and stable.