Free-floating thrombus in the aortic arch

Avelino, Marcelo Coelho; Miranda, Carla Lorena Vasques Mendes de; Sousa, Camila Soares Moreira de; Bastos, Breno Braga; Sousa, Rafael Soares Moreira de

doi:10.1590/0100-3984.2016.0083

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Diagnosing FFT in COVID-19 can be rather difficult because the clinical presentation of FFT can significantly vary, ranging from life-threatening distal embolization to other organs to asymptomatic disease [ 16 ]. While many FFTs are diagnosed after an embolic event, some are found incidentally or postmortem [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Once discovered, prompt treatment of an FFT is usually suggested, given that the rate of free-floating thrombi embolization has been described to be as high as 75%, compared with 12% for adherent thrombi [ 16 , 18 ]. Currently, however, the optimal treatment approach for aortic FFT is unclear, including those that occur in the setting of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Free-floating thrombus (FFT) of the aorta is a rare condition characterized by a nonadherent portion of thrombus floating within the aortic lumen. Clinical presentation of FFT ranges from asymptomatic disease to symptoms related to embolization of the brain and peripheral organs [ 1 ]. FFT can be a result of hypercoagulability caused by malignancy, prior surgery, or turbulent blood flow and has an approximately 75% risk of distal embolization [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Free-Floating Thrombus of the Aorta: A Rare Complication of COVID-19-Induced Hypercoagulability

Shaik,

Nayeem,

Ahmed

et al. 2024

Cureus

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Free-floating thrombus (FFT) of the aorta is a rare condition characterized by a nonadherent portion of thrombus floating within the aortic lumen. Hypercoagulability is a well-known complication of COVID-19 infection, and thromboses related to COVID-19-related hypercoagulability commonly present in the form of venous or arterial thrombosis such as deep vein thrombosis (DVT), pulmonary embolism (PE), ischemic stroke, and myocardial infarction. Unfortunately, FFT associated with COVID-19 infection has been rarely reported in the literature. We report the case of a 53-year-old female patient with an unusual presentation of a pedunculated thrombus in the descending thoracic aorta caused by COVID-19-related hypercoagulability. The patient was treated with anticoagulation therapy and did not require invasive procedures. FFT is a rare but potentially catastrophic complication of COVID-19 infection. Rapid diagnosis and treatment are vital to prevent complications like limb ischemia and stroke.

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“…Floating aortic thrombi (FLOAT) are rare and mainly diagnosed after an embolic event such as acute lower limb ischemia, renal infarction, and bowel ischemia [ 1 – 3 ]. FLOAT are mainly secondary to atherosclerotic disease of the aortic wall [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Floating aortic arch thrombus involving the left common carotid artery complicated with ischemic stroke associated with cocaine use

et al. 2022

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Background Floating aortic thrombi (FLOAT) are rare, with very few cases attributed to cocaine use. We report a new case of FLOAT involving the left common carotid artery due to cocaine use, for the first time, complicated with acute ischemic stroke. Methods We present in detail our case report, and then, a literature search in PubMed and Scopus was performed up to March 20, 2022, to review the reported cases of aortic thrombus associated with cocaine use. Results A 39-year-old man with a history of smoking and daily cocaine use was admitted to our stroke unit for acute left-hemispheric symptoms due to carotid-Sylvian occlusion. CT angiography of the supra-aortic trunks showed FLOAT involving the left common carotid artery. The thrombus was removed successfully by endovascular thrombectomy with recanalization of carotid-Sylvian occlusion. Our literature search yielded seven reported cases of aortic thrombus due to cocaine use revealed by lower limb ischemia (3 patients), renal infarction (1 patient), abdominal pain (1 patient), bowel ischemia (1 patient), and lower limb ischemia with renal infarction (1 patient). Conclusion Aortic thrombus should be suspected in patients without overt cardiovascular risk factors but with a recent history of cocaine use who presents with acute ischemic stroke.

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Free-floating thrombus in the aortic arch

Cited by 9 publications

References 5 publications

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

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

Free-Floating Thrombus of the Aorta: A Rare Complication of COVID-19-Induced Hypercoagulability

Floating aortic arch thrombus involving the left common carotid artery complicated with ischemic stroke associated with cocaine use

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