Floating thrombus in the ascending aorta: A rare cause of peripheral emboli

Kalangos, Afksendiyos; Baldovinos, Ary; Vuille, Cédric; Montessuit, Michel; Faidutti, B

doi:10.1016/s0741-5214(97)70161-7

Cited by 60 publications

(66 citation statements)

References 17 publications

(1 reference statement)

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“…Kalangos et al suggested that the role of a transient hypercoagulable state that is not well understood at the present time, in a site such as the aortic sinus of Valsalva where turbulence could act as a contributing factor, remains a reasonable possibility. 2 So, we speculate that the etiology of this case is the result of the combination of alcoholic dehydration and Af.…”

Section: Discussionmentioning

confidence: 81%

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Floating thrombus in the ascending aorta

Hisagi

Morota

Endo

et al. 2007

Gen Thorac Cardiovasc Surg

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Floating thrombus in the ascending aorta is an uncommon source of embolism. We report a case of a 61-year-old man who was admitted to our hospital for transient brain ischemic attack. Transesophageal echocardiography showed a floating mass on the sinotubular junction. We started anticoagulation therapy immediately and performed surgical removal of the mass 5 days after the admission. Postoperative course was uneventful. He is now in good health and has no sign of recurrence. The etiology of this case is unclear, and the strategy is difficult to determine in terms of cerebral complications.

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Section: Discussionmentioning

confidence: 81%

“…If we fi nd a fl oating mass in the left-side heart or in the aorta, especially in the ascending aorta, we should start treatment to the mass immediately before major embolic complications occur. [1][2][3] We report a case of fl oating thrombus in the ascending aorta. Surgical removal of the thrombus was performed successfully.…”

Section: Introductionmentioning

confidence: 97%

Floating thrombus in the ascending aorta

Hisagi

Morota

Endo

et al. 2007

Gen Thorac Cardiovasc Surg

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“…What is unusual about this case is that the remainder of the aorta, mesenteric vessels and coronaries were all without any atherosclerosis. A pubmed search conducted using the terms (mobile thrombus) and (aorta) resulted in 102 publications, ten of which involved patients with mobile aortic thrombi without identified risk factors [3][4][5][6][7][8][9] (see Table 1). …”

Section: Discussionmentioning

confidence: 99%

“…Floating thrombi in the ascending aorta have a clinical presentation that includes acute or chronic recurrent cerebrovascular or peripheral embolic symptoms [5], which suggests an embolic path through the branches of the aortic arch or down the distal aorta. To our knowledge, this is the first case of ascending aortic thrombus with only emboli to the abdominal viscera.…”

Section: Discussionmentioning

confidence: 99%

Ischemic bowel due to embolization from an isolated mobile thrombus of the ascending aorta: a case report and review of the literature

Hechtman

Lento

Scordi-Bello

2011

J Thromb Thrombolysis

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Aortic thrombi are commonly present in atherosclerotic and aneurysmatic aortas. Thrombus formation in an aorta with or focal atherosclerosis in a patient without risk factors is rare. A 63-year-old woman with dementia and hypothyroidism presented with hypotension and respiratory distress. Work-up revealed leukocytosis, sinus tachycardia, and proximal small bowel obstruction. At emergent laparotomy, a superior mesenteric artery thomboembolus was identified with necrosis of surrounding bowel. The patient expired on hospital day five. Autopsy revealed a 1.4 cm thrombus overlying an isolated atherosclerotic plaque in the ascending aorta and infarctions of the spleen, liver, and right kidney as well as occlusive thromboembolism of the superior mesenteric artery. This case report illustrates lethal complications from an unsuspected aortic thrombus. Work-up for patients presenting with signs of peripheral embolization, or in this case, necrotic bowel, should include the aorta as a source of embolic thrombi.

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“…Since the ideal treatment of mobile aortic thrombi without atheromatosis has not been ascertained, the immediate treatment is usually selected according to the underlying pathology and patients' comorbidities. It is also emphasized that surgery should always be considered in the absence of risk factors for surgery (e.g., atherosclerosis), especially if systemic embolism occurs (10,11).…”

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confidence: 99%

Floating aortic thrombus in a patient with non-hodgkin's lymphoma

Aksu

Demirkazık²

2008

Diagn Interv Radiol

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Only few cases of aortic thrombus in the absence of atherosclerosis, dissection or aneurysm have been reported in the literature. Aortic thrombus is an uncommon condition even in hypercoagulability states like sepsis, polycytemia, disseminated intravascular coagulation, autoimmune diseases, pregnancy, and cancer (1). We report here computed tomography (CT) findings of a floating aortic thrombus that caused peripheral embolism in a B-cell non-Hodgkin lymphoma patient in the absence of any other predisposing factors. Case reportAn ulcerovegetating mass in the stomach was detected in the upper gastrointestinal endoscopy of a 58-year-old man who had epigastric pain, abdominal distention, weight loss, night sweat and fever complaints. Biopsy revealed CD20 positive, B-cell non-Hodgkin lymphoma.For staging, thoracoabdominal CT was obtained with a 4-channel multidetector CT scanner with a 5 mm slice thickness after i.v. injection of 150 mL of iohexol at a rate of 3.5 mL/s. For thoracic CT the delay time was 25 s, and for abdominal CT the delay time was 60 s. On thoracic CT images, enlarged left supraclavicular, subcarinal, right paracardiac, bilateral internal mammary lymph nodes, thymus invasion, and bilateral pleural effusions were observed. Additionally, a floating thrombus originating from the aortic arch and extending into the descending thoracic aorta was detected. The thrombus was causing partial obstruction of the descending thoracic aorta lumen (Fig. 1). On sagittal reformatted images, it was observed that the thrombus clinged to the aortic wall with a very thin peduncle (Fig. 2). There were no signs of atherosclerosis, aneurysm, dissection, or cardiac thrombus. On abdominal CT scans, a retroperitoneal mass on the left, massive ascites, mesenteric lymphadenopathies and a wedge shaped splenic infarct were observed.Chemotherapy and anticoagulant therapy were immediately started after CT examination. At the 36th hour of chemotherapy and anticoagulant therapy, acute and progressive deterioration of liver and renal function tests and elevation of cardiac biomarkers were detected. Abdominal distension markedly increased, unconsciousness ensued, and peripheral circulation failed. Death occurred at the 40th hour of treatment. DiscussionAortic thrombus may lead to catastrophic consequences as a result of acute or chronic recurrent cerebrovascular, coronary, visceral and peripheral embolism. The mortality rate can be as high as 50%, if not treated. Embolic complications can usually be prevented with early diagnosis and treatment (1, 2). At least 8-65% of aortic emboli originate from the left atrium secondary to atrial fibrillation. Primary thrombus ABSTRACT Aortic thrombus is a rare condition unless there is an underlying wall pathology such as atherosclerosis, aneurysm, dissection, or thrombus within the left heart chambers. It causes visceral or peripheral embolisms, and is fatal, if not treated. These characteristics make early diagnosis and therapy essential. We report here the computed tomography findings of a floa...

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Floating thrombus in the ascending aorta: A rare cause of peripheral emboli

Cited by 60 publications

References 17 publications

Floating thrombus in the ascending aorta

Floating thrombus in the ascending aorta

Ischemic bowel due to embolization from an isolated mobile thrombus of the ascending aorta: a case report and review of the literature

Floating aortic thrombus in a patient with non-hodgkin's lymphoma

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