Percutaneous thrombectomy of mural aortic thrombus using intravascular ultrasound guidance

Murter, Christopher D.; Sigdel, Abindra; Dwivedi, Amit J.; Wayne, Erik

doi:10.1016/j.jvscit.2019.06.013

Cited by 6 publications

(14 citation statements)

References 6 publications

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“…Patients were followed for 1 month and had no residual thrombi, recurrence, or new thrombotic events. 33 …”

Section: Resultsmentioning

confidence: 99%

“…The anticoagulants of choice were low-molecular-weight heparin or unfractionated heparin, later switching to warfarin at hospital discharge. There is one case of thoracic mobile thrombus treated with direct oral anticoagulants with success 33 and one case of a sessile thrombus of aorta that was treated with embolectomy. At hospital discharge, direct oral anticoagulant was prescribed with complete resolution after 2 years.…”

Section: Discussionmentioning

confidence: 99%

“…There are a few reports of thoracic aortic thromboaspiration 44 - 46 and abdominal aortic thromboaspiration 33 with favorable outcomes. As studies advance, in the future this may become an option for treatment of abdominal aortic thrombus and may even be considered an option for treatment of mural aortic thrombus.…”

Section: Discussionmentioning

confidence: 99%

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Mobile thrombus of the abdominal aorta: a narrative review

et al. 2022

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A primary aortic mural thrombus (PAMT) is defined as a thrombus attached to the aortic wall in the absence of any atherosclerotic or aneurysmal disease of the aorta or any cardiac source of embolus. It is a rare entity that has high morbidity and mortality. There is no consensus on the ideal treatment of PAMT. The objective of this paper is to review the possibilities for treatment of mobile abdominal aortic mural thrombus. Endovascular therapy and open surgery appear to be the best options for treatment of mobile abdominal aortic mural thrombus. Thus, in patients with favorable anatomy, endovascular therapy is probably the treatment choice, while in those with unfavorable anatomy, open surgery is probably the best option for treatment of a mobile abdominal aortic thrombus. It is important to emphasize that anticoagulation alone can be used as a non-aggressive option and, if this fails, endovascular or surgical methods can then be employed.

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“…Patients were followed for 1 month and had no residual thrombi, recurrence, or new thrombotic events. 33 …”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Mobile thrombus of the abdominal aorta: a narrative review

et al. 2022

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“…In other cases endovascular procedures, including stent graft, mechanicalthrombectomy, were used, despite the risk of embolization during the procedure. 1,9-11…”

Section: Discussionmentioning

confidence: 99%

A Mobile Thrombus of the Thoracic Aorta

Wolf

Fajer

Haddad

et al. 2022

Vasc Endovascular Surg

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A mobile thrombus of the thoracic aorta is a rare entity, which might have serious clinical manifestations, including arterial emboli. Due to its low incidence, there is no consensus regarding the most adequate management of mobile thoracic aorta thrombus. The current case describes a patient with Polycythemia Vera and myeloproliferative neoplasm, who presented with mobile thrombus of the thoracic aorta, manifested by blue toe syndrome and asymptomatic splenic infarct. She was treated conservatively with anti-coagulation and Iloprost alongside the patient’s permanent treatment of Aspirin, Hydrea and Atorvastatin. Under this treatment, the thrombus resolved completely, and the blue toes improved, except for one.

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“…However, there is a risk of peri-procedural embolization and arterial wall injury that can be limited by the use of intravascular ultrasound guidance. 14 , 15 Overall, it could be a promising technique in patients with a high surgical risk.…”

Section: Discussionmentioning

confidence: 99%

Hyperacute simultaneous cardiocerebral infarction related to floating thrombus in the ascending aorta: a case report

Issa¹,

Gallissot²,

Cochet³

et al. 2021

European Heart Journal - Case Reports

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Background Ascending aortic thrombus has been reported in several case reports, often revealed by peripheral embolization, but very few revealed by cardiocerebral infarction. Moreover, there is no defined treatment strategy. Case Summary An 83-year-old woman was admitted to our intensive care unit for concurrent acute myocardial infarction (AMI) and acute stroke, both with the presence of an embolism. Imaging revealed a floating thrombus in the ascending aorta. The thrombus resolved after anticoagulant therapy was administered, and there was no subsequent embolism recurrence. Discussion Floating thrombus in the ascending aorta is an unusual cause of AMI. The main mechanisms of thrombus formation include erosion of an atherosclerotic plaque, but it can also form without tissue abnormality with the probable implication of Virchow’s triad. However, the precise mechanism for thrombogenesis remains unknown. In patients with a low surgical risk, we should consider surgical treatment, especially as anticoagulant therapy does not appear to reduce the risk of arterial embolization. Thrombolysis and endovascular interventions have also proven effective in certain cases. Overall, in patients with high surgical risk, decision will have to be made on a case-by-case basis. Learning point Ascending aortic thrombus should be suspected in cases of multiple systemic embolisms. Simultaneous AMI and ischemic stroke should lead to a search for arterial embolization, and it could be useful to perform a head and chest CT scan prior to cardiac catheterization in case of neurologic symptoms in the context of AMI.

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Percutaneous thrombectomy of mural aortic thrombus using intravascular ultrasound guidance

Cited by 6 publications

References 6 publications

Mobile thrombus of the abdominal aorta: a narrative review

Mobile thrombus of the abdominal aorta: a narrative review

A Mobile Thrombus of the Thoracic Aorta

Hyperacute simultaneous cardiocerebral infarction related to floating thrombus in the ascending aorta: a case report

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