Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism

N Tsilimparis; U Hanack; G Pisimisis; S Yousefi; C Wintzer; R I Rückert

doi:10.1016/j.ejvs.2010.11.004

Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism

Standard

Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism. / Tsilimparis, N; Hanack, U; Pisimisis, G; Yousefi, S; Wintzer, C; Rückert, R I.

in: EUR J VASC ENDOVASC, Jahrgang 41, Nr. 4, 04.2011, S. 450-457.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Tsilimparis, N, Hanack, U, Pisimisis, G, Yousefi, S, Wintzer, C & Rückert, RI 2011, 'Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism', EUR J VASC ENDOVASC, Jg. 41, Nr. 4, S. 450-457. https://doi.org/10.1016/j.ejvs.2010.11.004

APA

Tsilimparis, N., Hanack, U., Pisimisis, G., Yousefi, S., Wintzer, C., & Rückert, R. I. (2011). Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism. EUR J VASC ENDOVASC, 41(4), 450-457. https://doi.org/10.1016/j.ejvs.2010.11.004

Vancouver

Tsilimparis N, Hanack U, Pisimisis G, Yousefi S, Wintzer C, Rückert RI. Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism. EUR J VASC ENDOVASC. 2011 Apr;41(4):450-457. https://doi.org/10.1016/j.ejvs.2010.11.004

Bibtex

@article{d86fd3ede018498c8efe6d82f17359d4,

title = "Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism",

abstract = "INTRODUCTION: Mural thrombus of the thoracic aorta is a rare clinical finding in the absence of aneurysm or atherosclerosis.METHODS: The medical records of all patients diagnosed with a thrombus of a non-aneurysmatic and non-atherosclerotic descending thoracic aorta (NAADTA) and treated by the senior author between 04/1997 and 04/2010 were reviewed.RESULTS: Eight patients with mural thrombus of the NAADTA were identified. Arterial embolism was the main clinical finding in all cases and involved the lower extremities (n = 6), mesenteric (n = 3) or renal arteries (n = 2). Hypercoagulable disorders were present in 3 cases and a concurrent malignancy in another 3. Two patients underwent open surgery while 4 patients were treated conservatively with anticoagulation. Of the remaining 2 patients, one was treated with a thoracic stent-graft and aorto-biiliac bypass and the other one with transfemoral thrombectomy. Technical success was achieved in all surgical cases and thrombus resolution or stable disease in the conservative management group. No thrombus recurrence was observed during a mean follow-up of 49 months.CONCLUSION: The management of mural thrombus in NAADTA represents a challenge, especially in case of malignant disease or hypercoagulable disorder as a potential underlying pathology and should be individualized. Although no consensus exists in the literature, therapeutic anticoagulation is proposed as first-line therapy. The indication for surgical intervention results from contraindication to anticoagulation, mobile thrombus or recurrent embolism. Whenever possible, endovascular therapy should be preferred.",

keywords = "Aged, Angiography, Digital Subtraction, Anticoagulants/therapeutic use, Aorta, Thoracic/diagnostic imaging, Aortic Diseases/diagnosis, Aortography/methods, Echocardiography, Transesophageal, Embolism/diagnosis, Endovascular Procedures, Female, Germany, Humans, Magnetic Resonance Angiography, Male, Middle Aged, Retrospective Studies, Risk Assessment, Risk Factors, Thrombosis/diagnosis, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Vascular Surgical Procedures",

author = "N Tsilimparis and U Hanack and G Pisimisis and S Yousefi and C Wintzer and R{\"u}ckert, {R I}",

year = "2011",

month = apr,

doi = "10.1016/j.ejvs.2010.11.004",

language = "English",

volume = "41",

pages = "450--457",

journal = "EUR J VASC ENDOVASC",

issn = "1078-5884",

publisher = "W.B. Saunders Ltd",

number = "4",

}

RIS

TY - JOUR

T1 - Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta--an unusual source of arterial embolism

AU - Tsilimparis, N

AU - Hanack, U

AU - Pisimisis, G

AU - Yousefi, S

AU - Wintzer, C

AU - Rückert, R I

PY - 2011/4

Y1 - 2011/4

N2 - INTRODUCTION: Mural thrombus of the thoracic aorta is a rare clinical finding in the absence of aneurysm or atherosclerosis.METHODS: The medical records of all patients diagnosed with a thrombus of a non-aneurysmatic and non-atherosclerotic descending thoracic aorta (NAADTA) and treated by the senior author between 04/1997 and 04/2010 were reviewed.RESULTS: Eight patients with mural thrombus of the NAADTA were identified. Arterial embolism was the main clinical finding in all cases and involved the lower extremities (n = 6), mesenteric (n = 3) or renal arteries (n = 2). Hypercoagulable disorders were present in 3 cases and a concurrent malignancy in another 3. Two patients underwent open surgery while 4 patients were treated conservatively with anticoagulation. Of the remaining 2 patients, one was treated with a thoracic stent-graft and aorto-biiliac bypass and the other one with transfemoral thrombectomy. Technical success was achieved in all surgical cases and thrombus resolution or stable disease in the conservative management group. No thrombus recurrence was observed during a mean follow-up of 49 months.CONCLUSION: The management of mural thrombus in NAADTA represents a challenge, especially in case of malignant disease or hypercoagulable disorder as a potential underlying pathology and should be individualized. Although no consensus exists in the literature, therapeutic anticoagulation is proposed as first-line therapy. The indication for surgical intervention results from contraindication to anticoagulation, mobile thrombus or recurrent embolism. Whenever possible, endovascular therapy should be preferred.

AB - INTRODUCTION: Mural thrombus of the thoracic aorta is a rare clinical finding in the absence of aneurysm or atherosclerosis.METHODS: The medical records of all patients diagnosed with a thrombus of a non-aneurysmatic and non-atherosclerotic descending thoracic aorta (NAADTA) and treated by the senior author between 04/1997 and 04/2010 were reviewed.RESULTS: Eight patients with mural thrombus of the NAADTA were identified. Arterial embolism was the main clinical finding in all cases and involved the lower extremities (n = 6), mesenteric (n = 3) or renal arteries (n = 2). Hypercoagulable disorders were present in 3 cases and a concurrent malignancy in another 3. Two patients underwent open surgery while 4 patients were treated conservatively with anticoagulation. Of the remaining 2 patients, one was treated with a thoracic stent-graft and aorto-biiliac bypass and the other one with transfemoral thrombectomy. Technical success was achieved in all surgical cases and thrombus resolution or stable disease in the conservative management group. No thrombus recurrence was observed during a mean follow-up of 49 months.CONCLUSION: The management of mural thrombus in NAADTA represents a challenge, especially in case of malignant disease or hypercoagulable disorder as a potential underlying pathology and should be individualized. Although no consensus exists in the literature, therapeutic anticoagulation is proposed as first-line therapy. The indication for surgical intervention results from contraindication to anticoagulation, mobile thrombus or recurrent embolism. Whenever possible, endovascular therapy should be preferred.

KW - Aged

KW - Angiography, Digital Subtraction

KW - Anticoagulants/therapeutic use

KW - Aorta, Thoracic/diagnostic imaging

KW - Aortic Diseases/diagnosis

KW - Aortography/methods

KW - Echocardiography, Transesophageal

KW - Embolism/diagnosis

KW - Endovascular Procedures

KW - Female

KW - Germany

KW - Humans

KW - Magnetic Resonance Angiography

KW - Male

KW - Middle Aged

KW - Retrospective Studies

KW - Risk Assessment

KW - Risk Factors

KW - Thrombosis/diagnosis

KW - Time Factors

KW - Tomography, X-Ray Computed

KW - Treatment Outcome

KW - Vascular Surgical Procedures

U2 - 10.1016/j.ejvs.2010.11.004

DO - 10.1016/j.ejvs.2010.11.004

M3 - SCORING: Journal article

C2 - 21145267

VL - 41

SP - 450

EP - 457

JO - EUR J VASC ENDOVASC

JF - EUR J VASC ENDOVASC

SN - 1078-5884

IS - 4

ER -