IntroductionDistal abdominal aortic thrombus is one of the rare entities in cardiovascular pathologies (1), and being spontaneous makes it unique. Only a few cases are encountered in clinical practice; thus, it is rare to diagnose before the patient suffers embolic complications. This makes the true incidence of this particular disease unknown (2) and therefore a high index of suspicion in patients without risk of coagulability states or any previous risk factors predisposing them to thrombus formation should be thought of; especially in patients presenting with signs of lower extremity ischemia which may mimic signs of venous insufficiency due to deep vein thrombosis (3). The management guidelines for this condition are still lacking as there is no clear consensus on whether, conservative pharmacological versus endovascular surgery, is the best option (3). These guidelines are referenced from developed countries, which possess the full availability of resources and equipment, as opposed to our medical setting. In this case, we present a 69-year-old female of Asian descent who was diagnosed with distal aortic occlusion of approximately more than ninety percent (90%) and was managed with intra-arterial papaverine and streptokinase infusion before being referred for endovascular therapy to salvage the limb.
