Grip O, et al. - Using the Swedish nationwide vascular database (Swedvasc), researchers conducted a population-based cohort study of patients with acute aortic occlusion (AAO), a rare and life-threatening event. In addition, they assessed the outcome of surgical treatment among these patients. During the 21 year study period (1994–2014), they included 693 cases [Mean ± SD age: 69.9 ± 11.2 years; 352 patients (50.8%) women; mean ± SD length of follow up: 5.2 ± 5.5 years] of surgical treatment for AAO, with a yearly incidence of 3.6 per million inhabitants. Bilateral acute limb ischemia was the presenting condition in most patients (596 patients, 86.0%). The aetiology of AAO was native artery thrombosis, saddle embolus, and occluded graft/stent/stent grafts in 458 (66.1%), 152 (21.9%) and 83 (12.0%) patients, respectively. During the study period, they observed an increase in the proportion of occluded grafts/stent/stent grafts (n = 14 [6.7%] in 1994–2000 vs. n = 45 [17.4%] in 2008–2014; p < .001) with a simultaneous reduction of arterial thrombosis (n = 149 [71.6%] in 1994–2000 vs. n = 158 [61.2%] in 2008–2014). Thirty-nine patients (8.5%) underwent major amputation above the ankle, and death of 140 patients within 30 days of surgery (20.2%) was reported. They observed lower 30-day mortality rate after occluded grafts/stents/stent grafts (eight patients [9.6%]) and higher 30-day mortality rate after saddle embolus (47 patients [30.9%])). Observations revealed a reduction in mortality after surgical treatment of AAO over time, yet there was a significant mortality rate throughout the study period. Over time, an increase in the proportion of AAO secondary to occluded grafts/stents/stent grafts was observed.