A Case of Mobile Aortic Arch Thrombus with Systemic Embolisation—A Management Dilemma

Dhillon, Priyanka; Jayasinghe, Rohan; Niranjan, S.

doi:10.1016/j.hlc.2013.09.009

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…The location of the thrombus is a major decisive factor when choosing the appropriate method of treatment. The presence of a thrombus in the ascending aorta has often led to the surgical approach [3], while endovascular [17] or medical treatments were preferred for thrombi located in the aortic arch and descending and abdominal aorta [18,19]. Furthermore, the hemodynamic stability is also a deciding factor.…”

Section: Discussionmentioning

confidence: 99%

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction—Case Report

et al. 2021

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We present the case of a 50-year-old male, with no cardiovascular risk factors other than smoking, that presented with acute chest pain, revealed to be an acute myocardial infarction with a large thrombus located in the ascending aorta. Such findings are rare in a patient with no other afflictions, such as atherosclerosis, aortic aneurysm, or aortic wall injury (surgical or traumatic). There is no specific pathway regarding the management of ascending aorta thrombus in such a patient; therapeutic options include surgical, interventional, or medical methods. Surgical thrombectomy was performed in this case, considering the high risk of systemic embolism and stroke and the hemodynamic stability of the patient.

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Section: Discussionmentioning

confidence: 99%

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction—Case Report

et al. 2021

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“…According to the published data location of thrombus strongly affects the possible therapeutic strategies. While thrombi in the abdominal aorta or its branches are preferable treated conservatively [5,6] endovascular stenting is considered in cases involving the descending or abdominal aorta [7]. Once intraluminal thrombus in the ascending aorta or aortic arch represent a contraindication for the new evolving stent graft devices mortality and morbidity of a cardiosurgical approach and thrombus-removal have to be weight against the risk of distal or even vast cerebral embolization that would remain with conservative anticoagulation therapy.…”

Section: Discussionmentioning

confidence: 99%

Acute peripheral ischemia in healthy female patient: an indirect and unanticipated diagnosis of spontaneous thrombus in the aortic arch

Rings

Schwegler

Papadopoulos

et al. 2020

J Cardiothorac Surg

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Background In this case we discuss the management of a pediculated floating thrombus in the aortic arch which led to peripheral embolization and acute ischemia oft he left leg. Case presentation A healthy 46 year old female patient presented with pain in her left leg and progressive numbness. Computed Tomography Angiography (CTA) showed an acute ischemia of the left leg (Rutherford 2 B) with a 2 cm thrombus distal of the aortic bifurcation. Emergency operation with embolectomy, selective thrombembolectomy and patch plasty on the tibioperoneal trunk and local lysis was performed. As part of a further diagnostic examination a thoracic CT scan has been performed revealing a pediculated-floating 2 cm thrombus in the aortic arch. Four days after the initial operation thrombus excision via a minimally invasive access way has been performed. After initiation of the extracorporeal circulation, selective unilateral antegrade cerebral perfusion has been established in mild (30–32 °C) systemic hypothermia. Patients postoperative course was uneventful. Histological evaluation of the mass demonstrated thrombotic material without evidence of infection or malignacy. Conclusion A pediculated spontaneous thrombus may develop in aortic arch in patients without traditional risk factors or family history of embolic events. Two stage operation was feasible and safe.

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“…No treatment guidelines for an aortic thrombus are currently available. If the lesion is identified as a thrombus before the operation and is located in the descending aorta, abdominal aorta, or its branches, most surgeons prefer to use anticoagulants [2, 3] and implant an endovascular stent in the descending aorta [4]. Anticoagulants include low-molecular-weight heparin, apixaban, and warfarin.…”

Section: Discussionmentioning

confidence: 99%

Huge thrombus in the ascending aorta: a case report and literature review

Wang

Cao

et al. 2019

J Cardiothorac Surg

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Background A floating thrombus in the ascending aorta is occasionally found in clinical practice. The treatment for such lesions is poorly defined and mainly depends on the clinical experience of the surgeons. Case presentation We herein report a case involving a 22- × 22- × 45-mm space-occupying lesion in the ascending aorta. The patient was successfully treated with surgical intervention. Thrombectomy and ascending aorta replacement were performed to prevent systemic embolization. Histopathological examination revealed that the lesion was a thrombus. Conclusions Aortic computed tomography angiography is a useful examination technique for patients with aortic thrombi. Resection of the thrombus can effectively reduce the risk of recurrent embolism.

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A Case of Mobile Aortic Arch Thrombus with Systemic Embolisation—A Management Dilemma

Cited by 8 publications

References 19 publications

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction—Case Report

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction—Case Report

Acute peripheral ischemia in healthy female patient: an indirect and unanticipated diagnosis of spontaneous thrombus in the aortic arch

Huge thrombus in the ascending aorta: a case report and literature review

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