Descending thoracic aortic mural thrombus presentation and treatment strategies

Abstract

Whereas mural thrombus of the thoracic aorta is uncommon, it must be considered in the differential diagnosis of embolic events. Although endovascular therapy may be a useful first-line option for TAMT with reports of positive outcomes in select literature, further study of this treatment option is required.

Large de novo ascending aortic thrombus successfully treated with anticoagulation

“…There have only been prior case reports in the ascending aorta 1 , 2 and descending aorta. 3 The exact mechanism of thrombus formation in these patients is not well understood. 4 Aortic surgery or treatment with anticoagulation agents are common management strategies that have been described previously.…”

Surgical treatment of patient with floating clot in ascending aorta

“…Многие авторы предпочитают антикоагулянтную терапию в сочетании с дистальной эмболэктомией или тромбэктомией из пораженной части аорты. Другие считают правильным использовать только антикоагулянтную терапию, исключая любое хирургическое вмешательство [2]. Лучшая стратегия описана в метаанализе Z. Fayad и соавт.…”

“…Обзор зарубежной медицинской литературы показал лишь единичные случаи описания флотирующего тромба в дистальной части восходящей аорты [2]. Это связано с повышенной скоростью кровотока в проксимальных отделах аорты.…”

Management and clinical outcome of concomitant pulmonary embolism and paradoxical saddle aortic arch embolism

“…Aortic thrombosis can also be due to underlying atherosclerotic disease with superimposed acute thrombus or hypercoagulability states 5–7. Free floating thrombus in a diseased thoracic aorta complicated by thromboembolic episodes may be treated surgically by open thrombectomy, endovascular techniques or non-operatively with anticoagulation or thrombolysis 8–11…”