Incidental descending thoracic aortic thrombus: the conundrum of medical versus surgical therapy

Khine, Kay; Toor, Amit; Khalighi, Koroush; Krishnamurthy, Mahesh

doi:10.1080/20009666.2019.1684230

Cited by 5 publications

(5 citation statements)

References 12 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is the primary reason patients with atrial fibrillation are considered for anticoagulation. We could not find any prior reports of POCUS assessment of an aortic thrombus in the proximal abdominal aorta, as other reports detail use of CT and cardiology-performed echocardiogram 3 , 10 , 11 , 12 .…”

Section: Discussionmentioning

confidence: 87%

See 1 more Smart Citation

Role of POCUS in Assessing an Acute Aortic Thrombus

Boivin,

Emily Mensel,

Trent She

2023

pocus

View full text Add to dashboard Cite

A 67-year-old female patient presented with abdominal pain with a recent diagnosis of paroxysmal atrial fibrillation. Computed tomography (CT) of the abdomen demonstrated a filling defect concerning for an aortic thrombus. Point of care ultrasound (POCUS) confirmed a mobile thrombus in the proximal abdominal aorta in close proximity to several major arterial branches, leading to urgent surgical consultation due to a concern for mesenteric and end-organ ischemia. POCUS played a role in determining patient management in this novel case, and the patient was anticoagulated and ultimately discharged from the hospital.

show abstract

Section: Discussionmentioning

confidence: 87%

“…Previous literature suggests multiple potential causes of aortic thrombi, including intrinsic aortic pathology such as dissection or abdominal aortic aneurysm (AAA), or extrinsic causes such as hypercoagulability 1 , 2 , 3 , 4 , 5 . Both the aortic thrombus and associated intrinsic aortic pathology can be visualized with POCUS.…”

Section: Discussionmentioning

confidence: 99%

Role of POCUS in Assessing an Acute Aortic Thrombus

Boivin,

Emily Mensel,

Trent She

2023

pocus

View full text Add to dashboard Cite

show abstract

“…Seventeen percent of these cases had evidence of distal embolization. Patients may present with chest pain, abdominal pain, or even asymptomatic pain [10][11][12]. However, the detrimental sequelae, such as acute ischemic strokes, abdominal infarction, and acute limb ischemia, are often the initial presenting signs of an aortic thrombus [1].…”

Section: Discussionmentioning

confidence: 99%

“…In an interesting case of TAMT with phospholipid syndrome, the patient was also infected with the novel SARS-CoV-19. This reflects that dual contributors may be present, and specifically that the viral sequelae of COVID-19 may unfold as an independent risk factor for central clot development [11].…”

Section: Discussionmentioning

confidence: 99%

A Case of Thoracic Aortic Mural Thrombus and Multiple Hypercoagulable Etiologies

Wagner,

Lantz

2024

Cureus

View full text Add to dashboard Cite

Thoracic aortic mural thrombi (TAMT) are rare yet a significant cause of emboli and mortality. Hypercoagulability is thought to play a role in pathogenesis. A common association is prothrombin G20210A mutation. We present a case of an 87-year-old man with an incidentally found TAMT in the setting of prothrombin mutation, metastatic prostate cancer, and a myeloproliferative disorder. The patient had several causes activating Virchow's hypercoagulability principle, contributing to a centrally located clot. Because of its paucity in the literature, we advocate for further research concerning treatment modalities of TAMTs as well as an additional and timely workup for hypercoagulable states to prevent further calamity.

show abstract

“…The most devastating complication of aortic thrombosis is distant embolization to different parts of the body that can lead on most occasions to ischemic stroke, acute limb ischemia, or mesenteric ischemia. It was estimated that more than 70% of aortic thrombosis cases develop embolic complications [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Aortic arch thrombosis complicated by an embolic stroke in a patient with COVID-19: A case report

Al-Mashdali

Al-Dubai

Al-warqi

2021

Annals of Medicine &Amp; Surgery

View full text Add to dashboard Cite

Introduction Aortic thrombosis is an uncommon condition with serious embolic complications. COVID-19 is currently recognized to be associated with both venous and arterial thrombosis. However, only a limited number of COVID-19 cases associated with aortic thrombosis have been reported in the literature since the beginning of the pandemic. Case presentation A 66-year-old lady was admitted to our hospital with acute ischemic stroke. Floating aortic arch thrombus was detected incidentally on CT imaging. Interestingly, the patient reported a history of fever and cough and was found to have COVID-19 pneumonia based on nasopharyngeal polymerase chain reaction (PCR) and imaging. The patient received three months of anticoagulant therapy, and repeated imaging study did not reveal any aortic thrombus. Clinical discussion COVID-19 related aortic thrombosis has been reported chiefly in severe cases. The SARS-CoV-2 can directly infect the endothelium of the vessels, which might explain the occurrence of arterial thrombosis in milder COVID-19 cases with the absence of the hyperinflammatory state. The management guideline for aortic thrombosis is scarce and based only on case reports and series. Conclusion Aortic thrombosis is a devastating condition that can be easily missed without clinical suspicion. Our patient developed acute ischemic stroke, most likely embolic originating from the aortic thrombus. The clinician should consider this condition in any COVID-19 patient presenting with thromboembolic events, such as stroke or acute limb ischemia. Further study is required to explain the pathophysiology of arterial/venous thrombosis in mild-moderate COVID-19 cases.

show abstract

Incidental descending thoracic aortic thrombus: the conundrum of medical versus surgical therapy

Cited by 5 publications

References 12 publications

Role of POCUS in Assessing an Acute Aortic Thrombus

Role of POCUS in Assessing an Acute Aortic Thrombus

A Case of Thoracic Aortic Mural Thrombus and Multiple Hypercoagulable Etiologies

Aortic arch thrombosis complicated by an embolic stroke in a patient with COVID-19: A case report

Contact Info

Product

Resources

About