Thoracic endovascular aortic repair for thoracic aortic mobile thrombus

Narh-Martey, Patrick; Szuchmacher, Mauricio; Cicchillo, Michael; Galdyn, Izabela

doi:10.1093/jscr/2012.6.17

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…14–16,20–23 As endovascular procedures have become more common for aortic and peripheral vascular diseases, there have been many reports of covering these lesions with endografts. 24–31 Higher rates of complications 1,29 as well as occasional catastrophic results 32 have also been reported with this approach in patients with phantom thrombus.…”

Section: Discussionmentioning

confidence: 98%

Initial and intermediate-term treatment of the phantom thrombus (primary non-occlusive mural thrombus on normal arteries)

et al. 2018

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An embolic event originating from thrombus on an otherwise un-diseased or minimally diseased proximal artery (Phantom Thrombus) is a rare but significant clinical challenge. All patients from a single center with an imaging defined luminal thrombus with a focal mural attachment site on an artery were evaluated retrospectively. We excluded all patients with underlying anatomic abnormalities of the vessel at the attachment site. Six patients with a mean age of 62.5 years were identified over a 2.5-year period. All patients had completed treatment for or had a current diagnosis of malignancy and none were on antiplatelets or other anticoagulants. Four thrombi originated in the aorta proximal to the renal arteries and one originated distal. One thrombus was found in the common carotid artery and one was in an arterialized vein graft. Mean follow-up was 22 months. None of the patients underwent removal or exclusion of the embolic source. With systemic anticoagulation, four of the phantom thrombi were resolved on imaging within 8 weeks, one resolved after 72 weeks. One phantom thrombus reoccurred after 6 months on reduced anticoagulant dosing. There was one acute and one death in follow-up (26 months). One patient required a partial foot amputation secondary to tissue necrosis from the initial thromboembolic event. Arterial thrombi forming on otherwise normal vessels are a distinct clinical entity. In patients with a phantom thrombus, a strategy of therapeutic anticoagulation for management of the embolic source seems to be safe and effective over both the short and intermediate-term.

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Section: Discussionmentioning

confidence: 98%

Initial and intermediate-term treatment of the phantom thrombus (primary non-occlusive mural thrombus on normal arteries)

et al. 2018

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“…A number of reports endorse the use of continued oral anticoagulation after either open surgical repair or TEVAR. 7,10,12,16,18,22,23,25,29,30,36 Some of these decisions may have been based on the desire to protect the distal vascular territory that was damaged by prior emboli and directly related to TEVAR placement. Thus, it is unclear whether the perceived success of surgical therapy is dependent on adjuvant medical therapy.…”

Section: Discussionmentioning

confidence: 99%