Aortic thrombosis resolved with enoxaparin in a patient treated with cisplatin-based regimen for small cell lung cancer

Chin, Sang Ouk; Lee, Jae Jin; Hwang, Yeon Hee; Han, Ji Sang; Maeng, Chi Hoon; Baek, Sun Kyung; Choi, Cheong Woong

doi:10.1007/s12185-010-0571-3

Cited by 13 publications

(8 citation statements)

References 14 publications

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“…Moreover, the presence of abdominal aortic aneurysms, cardiac disease, or neurological abnormalities such as limb paralysis is highly associated with the development of aortic thrombosis (2).…”

Section: Discussionmentioning

confidence: 99%

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Acute Aortic Thrombosis during Cisplatin Based Chemotherapy for Gastric Cancer

et al. 2013

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The development of aortic thrombosis without the presence of atheroscrelosis, dissection, or aneurysms is rare. A cancer-related hypercoagulable state is a well-known risk factor for venous thrombosis, however, atrial thrombosis has rarely been reported in cancer patients. Cisplatin-based chemotherapy is known to cause various side-effects. Detecting aortic thrombosis is important because it is a fatal condition. We herein present the first reported case of endo-aortic thrombosis occurring during cisplatin-based chemotherapy for gastric cancer.

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Section: Discussionmentioning

confidence: 99%

“…Only a few case of cisplatin-associated arterial thrombosis have been documented in patients with small cell lung cancer (2), testicular seminoma (3), esophageal adenocarcinoma (4), and cervical cancer (1).…”

Section: Introductionmentioning

confidence: 99%

Acute Aortic Thrombosis during Cisplatin Based Chemotherapy for Gastric Cancer

et al. 2013

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“…Thrombotic material adherent to the aortic wall is associated with atherosclerosis or aortic aneurysms in the vast majority of cases. 45,46 Primary aortic mural thrombus occurs in the absence of the aforementioned conditions, has been reported in case series, [47][48][49][50] and is associated in the majority of cases with systemic conditions like heparin-induced thrombocytopenia, 51,52 antiphospholipid syndrome, 53,54 underlying malignancy, [55][56][57] chemotherapy, 58,59 myeloproliferative neoplasms, 46 or thrombophilias. 56,60,61 In a retrospective study of 88 patients with acute limb ischemia, 19 were found to have an underlying aortic mural thrombus.…”

Section: Primary Aortic Mural Thrombusmentioning

confidence: 99%

Antithrombotic therapy in aortic diseases: A narrative review

Anand

2017

Vasc Med

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Aortic diseases are a heterogeneous group of disorders, including atherothrombotic conditions like aortic atheroma, cholesterol embolization syndrome, aortic mural thrombus, thrombus within an aneurysm, and large vessel vasculitis. In this review, we provide a summary of the current evidence regarding atherothrombotic diseases of the aorta, focusing on therapeutic avenues. In patients with previous stroke, aortic arch atheroma is recognized as a strong predictor of recurrent atheroembolism, and antiplatelet therapy alone is still associated with a high (11.1%) residual risk of recurrent stroke. In secondary prevention, the use of dual antiplatelet therapy or moderate intensity anticoagulation with warfarin may lower the risk of recurrent stroke at a cost of increased life-threatening bleeding. Thrombi adherent to the aortic wall are generally associated with underlying atherosclerosis or aneurysmal disease. Primary aortic mural thrombus is a rare condition, sometimes related with systemic prothrombotic or inflammatory diseases. Retrospective studies suggest that anticoagulation is beneficial in patients with mobile mural thrombus. The pathogenesis and consequences of thrombus in an aortic aneurysm, or in an endograft following endovascular aneurysm repair, have been studied, but the role of antiplatelet therapy in those two conditions is still unclear and should be driven by general cardiovascular risk prevention. The benefit of anticoagulation to reduce thrombus load is uncertain. Patients with large vessel vasculitis experience increased cardiovascular events secondary to inflammation-driven atherothrombotic processes. Antiplatelet therapy is recommended as part of the therapy for prevention of cardiovascular disease. Anticoagulation with warfarin has shown limited benefit in few retrospective studies.

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“…A small number of arterial thrombosis cases in patients with cancer have been reported, of complicating cancers such as lung cancer,9 oesophageal carcinoma,10 testicular seminoma11 and others.…”

Section: Discussionmentioning

confidence: 99%

In the nick of time: arterial thrombosis on starting combination chemotherapy in metastatic gastric adenocarcinoma

Boon¹,

Boon

2016

BMJ Case Reports

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A 70-year-old man newly diagnosed with metastatic gastric adenocarcinoma was started on standard first-line palliative chemotherapy with anthracycline (epirubicin), platinum (oxaliplatin) and fluoropyrimidine (capecitabine); EOX combination chemotherapy. 5 days after the first cycle of chemotherapy, he presented with tachycardia with associated severe abdominal and lumbar pains. Initial investigations confirmed life-threatening metabolic acidosis with serum lactate of 9.7 mmol/L (normal range 0.5-2.2 mmol/L). CT angiogram identified acute arterial thrombosis within the abdominal aorta, lumbar and right common iliac artery, which was absent on staging contrast CT scan 6 weeks prior. The patient was immediately anticoagulated and chemotherapy discontinued. Urgent oncology and surgical opinions advised conservative management. The patient responded well to early treatment and survived this acute episode. He was subsequently started on life-long treatment dose enoxaparin and second-line single agent chemotherapy with docetaxel (taxotere), with no reported complications.

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Aortic thrombosis resolved with enoxaparin in a patient treated with cisplatin-based regimen for small cell lung cancer

Cited by 13 publications

References 14 publications

Acute Aortic Thrombosis during Cisplatin Based Chemotherapy for Gastric Cancer

Acute Aortic Thrombosis during Cisplatin Based Chemotherapy for Gastric Cancer

Antithrombotic therapy in aortic diseases: A narrative review

In the nick of time: arterial thrombosis on starting combination chemotherapy in metastatic gastric adenocarcinoma

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