Ascending aortic thrombus with multiple emboli associated with COVID-19

Schmidt, Portia; Vásquez, Javier; Gagliano, Bryce C.; Moore, Alastair; Roberts, Charles S.

doi:10.1080/08998280.2020.1834342

Cited by 7 publications

(14 citation statements)

References 7 publications

(7 reference statements)

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“… 4 Surgical interventions are warranted if there are systemic embolic complications from aortic thromboses. 3 Given these were not identified in this case and in view of the patient’s critical illness, the treating physicians decided against the surgical intervention.…”

Section: Descriptionmentioning

confidence: 94%

“… 1 2 Ascending aortic thrombosis is extremely rare due to higher pressures and blood flow but has been reported associated with embolic phenomena. 3 …”

Section: Descriptionmentioning

confidence: 99%

“…1 2 Ascending aortic thrombosis is extremely rare due to higher pressures and blood flow but has been reported associated with embolic phenomena. 3 COVID-19 causes a hypercoagulable state via multiple mechanisms including a profound systemic inflammatory response and cytokine storm, evidenced by increased D-dimer, prothrombin and fibrinogen levels. 1 These effects, along with prolonged immobilisation, complete Virchow's triad.…”

Section: Descriptionmentioning

confidence: 99%

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A rare case of multiple aortic thromboses associated with severe COVID-19 infection

et al. 2021

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Section: Descriptionmentioning

confidence: 94%

“… 1 2 Ascending aortic thrombosis is extremely rare due to higher pressures and blood flow but has been reported associated with embolic phenomena. 3 …”

Section: Descriptionmentioning

confidence: 99%

Section: Descriptionmentioning

confidence: 99%

See 1 more Smart Citation

A rare case of multiple aortic thromboses associated with severe COVID-19 infection

et al. 2021

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“…Most of the patients were treated medically using either therapeutic dose of enoxaparin (8 out of 21) or unfractionated heparin (UFH) (8 out of 21), with a resolution of thrombus on repeat imaging, suggesting medical therapy alone to be optimal. However, two patients underwent urgent mechanical thrombectomy in addition to full dose anticoagulation, with significant clinical improvement and favorable outcomes, suggesting need for individualized care based on severity and symptoms [20] , [21] . It is not clear from the current review which patients will benefit from each treatment modality.…”

Section: Discussionmentioning

confidence: 99%

Coexisting portal vein thrombosis and aortic thrombosis in a patient with COVID-19: A case report and literature review

Akella

Raj

Kannan

et al. 2022

IDCases

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“…Given the novelty of the SARSCoV-2 virus, the incidence of FFT and the best course of treatment in COVID-19 is still unknown. Although there are reports of COVID-19-associated arterial thromboembolisms, including FFT, there has been only 1 other report of thrombectomy for a COVID-19-associated thrombus discussed in the literature [ 7 – 10 ]. The present case describes a patient with COVID-19-related acute respiratory distress syndrome found to have an incidental FFT that was successfully treated with percutaneous vacuum-assisted aortic thrombectomy.…”

Section: Introductionmentioning

confidence: 99%

A Case of COVID-19-Associated Free-Floating Aortic Thrombus Successfully Treated with Thrombectomy

et al. 2021

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Patient: Male, 61-year-old Final Diagnosis: Aortic thrombosis Symptoms: Shortness of breath Medication:— Clinical Procedure: Thrombectomy Specialty: Infectious Diseases • General and Internal Medicine • Surgery Objective: Unusual clinical course Background: COVID-19 caused by SARS-CoV-2 infection has been associated with a hypercoagulable state in which patients can be at risk for developing venous and arterial thromboembolic events at a rate as high as 31%. A free-floating aortic thrombus (FFT) is a rare life-threatening complication of a hypercoagulable state. These thrombi require medical, endovascular, or surgical treatment. The optimal treatment modality for FFT occurring in the setting of COVID-19 remains unknown. We present a patient with a COVID-19-associated free-floating descending aortic thrombus that was treated with percutaneous vacuum-assisted thrombectomy (angio-VAC). Case Report: A 61-year-old man presented to the hospital with dyspnea and hypoxia and was diagnosed with severe COVID-19 pneumonia. Initial chest computed tomography angiography (CTA) did not show pulmonary emboli or thrombi. Inflammatory markers (D-dimer, lactate dehydrogenase, ferritin, fibrinogen) were tracked every other day. After several measurements of decreasing D-dimer values, there was a noticeable increase in D-dimer level and continued dependence on high levels of supplemental oxygen. A repeat chest CTA showed an FFT, confirmed by transesophageal echocardiogram. Cardiothoracic surgery and interventional radiology teams performed successful angio-VAC percutaneous removal, confirmed with intravascular ultrasound. The patient was subsequently discharged with a 3-month supply of apixaban. Conclusions: Minimally invasive endovascular removal of an FFT is a therapeutic option, as anticoagulation alone carries the risk of partial lysis and repeat embolization. Clinicians can consider this endovascular treatment option paired with therapeutic anticoagulation. Further guidelines on monitoring and treatment of possible COVID-19-associated thrombosis are needed, particularly when the risk of embolization is high.

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Ascending aortic thrombus with multiple emboli associated with COVID-19

Cited by 7 publications

References 7 publications

A rare case of multiple aortic thromboses associated with severe COVID-19 infection

A rare case of multiple aortic thromboses associated with severe COVID-19 infection

Coexisting portal vein thrombosis and aortic thrombosis in a patient with COVID-19: A case report and literature review

A Case of COVID-19-Associated Free-Floating Aortic Thrombus Successfully Treated with Thrombectomy

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