AORTIC MURAL THROMBUS

Authors

  • Juliana Varino Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Roger Rodrigues Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Bárbara Pereira Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Mário Moreira Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Óscar Gonçalves Serviço de Angiologia e Cirurgia Vascular, Centro Hospitalar e Universitário de Coimbra, Portugal

DOI:

https://doi.org/10.48729/pjctvs.145

Abstract

Aortic mural thrombus is a rare clinical finding in the absence of aneurysm or atherosclerosis but an important source of noncardiogenic emboli with a difficult diagnosis and a high rate of complications, including high mortality. It appears to occur more frequently in young adults usually with underlying pro-thrombotic disorder. With the increasing use of high resolution imaging, the asymptomatic mural thrombus became an increasingly frequent finding, but its potential for embolization or the best treatment are still a matter of debate. The management of mural thrombus in non-atherosclerotic aorta represents a challenge because no guidelines are available, and should be individualized. The therapeutic approach should include the triple aspects of aortic mural thrombus: primary disease anticoagulation treatment, surgical thrombectomy to solve embolic complications and endovascular/classical surgery to exclude the thrombus from the aorta. Historically therapeutic anticoagulation was proposed as first-line therapy and surgical intervention was reserved for mobile thrombus, recurrent embolism and contraindication for anticoagulation. However, it is associated with a 25-50% embolic recurrence rate, thrombus persistence in 35% and secondary aortic surgery in up to 31% of the cases. Recent data suggest that endovascular coverage of the aortic thrombus, when feasible, appears to be an effective and safe procedure with a low recurrence and re-embolization rates. In this article we review the published literature concerning this topic.

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Published

31-03-2019

How to Cite

1.
Varino J, Rodrigues R, Pereira B, Moreira M, Gonçalves Óscar. AORTIC MURAL THROMBUS. Rev Port Cir Cardiotorac Vasc [Internet]. 2019 Mar. 31 [cited 2022 Aug. 11];26(1):19-26. Available from: https://pjctvs.com/index.php/journal/article/view/145

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Review Article

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