Endovascular Treatment of Thoracic Aortic Floating Thrombus in Patients Presenting with Acute Lower Limb Ischemia

Nano, Giovanni; Mazzaccaro, Daniela; Malacrida, Giovanni; Occhiuto, Maria Teresa; Stegher, Silvia; Foresti, Davide; Giuseppe, Tealdi Domenico

doi:10.1155/2011/604362

Cited by 8 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The feasibility and efficiency of endografts as treatment modality on TAMT have been recently highlighted in the literature (23,24,27,29,30,(32)(33)(34)36,47). This treatment modality mandates a vascular team with a high level expertise in endovascular surgery and the availability of necessary logistic programs for the appropriate planning, sizing and accurate deployment of the stent.…”

Section: Discussionmentioning

confidence: 99%

“…Endovascular stenting has been recently suggested as a therapeutic option for TAMT (23,24,27,29,30,(32)(33)(34)36,47). Several publications reported their results with decrease of the size of residual thrombus and recurrent embolization in comparison to anticoagulation alone (27,29,34,36). Another benefit of the endovascular approach is the fact that it facilitates peripheral embolectomy through the same surgical access.…”

Section: Endovascular Treatment As a New Tool In The Therapeutic Armamentioning

confidence: 99%

See 1 more Smart Citation

A critical reappraisal of the treatment modalities of normal appearing thoracic aorta mural thrombi

et al. 2017

View full text Add to dashboard Cite

Mural thrombus in non-atherosclerotic or aneurysmatic thoracic aorta is a relatively uncommon entity. Currently there is no consensus on the appropriate therapeutic algorithm of its management. We aim to present the current knowledge on the treatment of thoracic aorta mural thrombi (TAMT) in minimally atherosclerotic vessels and we hope that the juxtaposed discussions will shed light on the uncharted waters regarding this rare syndrome. The MEDLINE/PubMed database was searched for publications with the medical subject "aortic mural thrombus" and keywords "thoracic", "embolism", "normal vessel", "minimally atherosclerotic vessel" or "treatment". We restricted our search to English language, till January 2017. The electronic literature search yielded 23 reports that were deemed appropriate for further analysis. Anticoagulation is the standard of care for the treatment of the thrombus whereas surgical and interventional treatment seems to be related with increased mortality and lower recurrence rates. TAMT treatment is controversial. Anticoagulants are the mainstay of treatment but surgery seems to gain ground in several settings as an only therapy or a combined treatment modality. More data are needed on the role of novel oral anticoagulants and endografts.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Endovascular Treatment As a New Tool In The Therapeutic Armamentioning

confidence: 99%

A critical reappraisal of the treatment modalities of normal appearing thoracic aorta mural thrombi

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Recently, as remarkable endovascular devices such as stent grafts or touching balloons have been developed, some case reports have described the successful treatment of intra-aortic thrombus by endovascular therapy [15]. However, endovascular procedures for treating mobile thrombus obviously carry a high risk of iatrogenic systemic embolism [11], and as the long-term results of these devices remain to be confirmed, their appropriate adaptation for young patients such as ours is not clear [16].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment for thoracoabdominal intra-aortic thrombus with multiple infarctions: a case report

et al. 2016

View full text Add to dashboard Cite

BackgroundMobile intra-aortic thrombus without atherosclerosis, aneurysm, or congenital coagulopathy is very rare, and there are few reports especially in young or middle-aged patients. Furthermore, there are presently no established guidelines or common strategies for the treatment of mobile intra-aortic thrombus.In this case report, we describe the first case of intra-aortic thrombus caused by secondary erythrocytosis and describe the recommended treatment strategy for intra-aortic thrombus.Case presentationWe report a case of an independent 40-year-old Asian man with a current history of heavy cigarette smoking who had sudden onset of abdominal and lumbar pain. Contrast-enhanced computed tomography revealed partial renal and splenic infarction, and he was transferred to our hospital. He also had a large mural thrombus in his thoracoabdominal aorta. Blood analysis on admission showed a hemoglobin level of 19.4 g/dL and hematocrit of 54.3 %; his international normalized ratio of prothrombin time, fibrin degradation products, and activated partial thromboplastin time levels were 1.02, 2.8 μg/ml, and 26.9 seconds respectively. We could find no abnormalities in protein C and protein S activity levels. Lupus anticoagulant and anti-cardiolipin antibody were both negative. He had no past medical history of arrhythmia and we found no signs of an arrhythmic event during admission.We promptly started anticoagulant therapy, but as the thrombus seemed at high risk of causing further critical infarction, we performed emergency aortic thrombectomy using partial extracorporeal circulation. To prevent dissemination of the thrombus during extracorporeal circulation, we first clamped his proximal and distal aorta on either side of the thrombus just before initiating extracorporeal circulation.After the aortotomy we removed a 14-cm length of intra-aortic thrombus without residual lesion. He was discharged from our hospital 20 days after surgery. From the results of his blood analysis, we considered the only cause of this thrombus was secondary erythrocytosis, which was probably induced by his current heavy cigarette smoking.ConclusionWe are the first to report such a thrombosis caused by secondary erythrocytosis and conclude that once the diagnosis of intra-aortic thrombus with systemic embolism is clear, emergency surgical removal of such a thrombus must be considered to prevent further embolic complications.

show abstract

“…3,4 Invasive management strategies have involved not only open thoracotomy and thrombectomy but also the use of endovascular therapy. 1,6 The use of TEE has been advocated in the diagnosis and management of thoracic aortic thrombi that are a potential source of systemic embolization. TEE has been emphasized to be a reliable method of diagnosing thoracic aortic diseases and for identification of aortic thrombi.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal Echocardiography–Guided Aortic Thrombectomy in a Patient With a Mobile Thoracic Aortic Thrombus

Krishnamoorthy

Bhatt

Nicolau

et al. 2011

Semin Cardiothorac Vasc Anesth

View full text Add to dashboard Cite

Thoracic aortic thrombi are a well-known cause of distal embolic phenomena. There is a paucity of case reports because of the rarity of this condition, and thus clear management guidelines are lacking. The authors present a case of a mobile thoracic aortic thrombus managed by a surgical approach. This report demonstrates how intraoperative transesophageal echocardiography (TEE) proved to be critical in guiding surgical management. The utility of TEE in the diagnosis and management of aortic thrombi is also discussed. In addition, currently reported management strategies for this complex condition are reviewed.

show abstract

Endovascular Treatment of Thoracic Aortic Floating Thrombus in Patients Presenting with Acute Lower Limb Ischemia

Cited by 8 publications

References 14 publications

A critical reappraisal of the treatment modalities of normal appearing thoracic aorta mural thrombi

A critical reappraisal of the treatment modalities of normal appearing thoracic aorta mural thrombi

Surgical treatment for thoracoabdominal intra-aortic thrombus with multiple infarctions: a case report

Transesophageal Echocardiography–Guided Aortic Thrombectomy in a Patient With a Mobile Thoracic Aortic Thrombus

Contact Info

Product

Resources

About