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Floating thrombus in the brachio-cephalic trunk.

D Singh1, R K Pinjala

  • 1Department of Vascular and Endovascular Surgery Nizam's Institute of Medical Sciences, Hyderabad, India. drdevendersingh@hotmail.com

VASA. Zeitschrift Fur Gefasskrankheiten
|March 16, 2006
PubMed
Summary

A rare floating thrombus in the brachiocephalic trunk caused severe right arm ischemia. Thrombectomy and anticoagulation successfully resolved the thrombus and restored limb function.

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Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine
  • Interventional Radiology

Background:

  • Floating thrombus in the brachiocephalic trunk (BCT) is exceptionally rare.
  • It poses significant risks of systemic embolization, including to the brain and periphery.
  • Non-aneurysmal, non-atherosclerotic BCT thrombi are particularly unusual.

Observation:

  • A patient presented with acute, advanced ischemia of the right upper limb.
  • Diagnostic CT angiogram confirmed a floating thrombus within the brachiocephalic trunk.
  • The clinical presentation indicated a high risk of embolic complications.

Findings:

  • Successful thrombectomy relieved the acute upper limb ischemia.
  • Aggressive anticoagulation therapy led to significant thrombus resolution within two weeks.
  • Complete resolution of the brachiocephalic trunk thrombus was achieved after one month.

Implications:

  • This case highlights the successful management of a rare BCT floating thrombus.
  • It underscores the efficacy of combined thrombectomy and anticoagulation for limb salvage.
  • Early diagnosis and intervention are crucial to prevent catastrophic embolic events.

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