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Calcified obstructive disease of the aortic isthmus
1Service de Chirurgie Thoracique et Cardio-Vasculaire, Centre Hospitalier et Universitaire, Caen, France.
Annals of Vascular Surgery
|March 1, 1990
Insights
A large aortic thrombus, originating from an ulcerated plaque, caused significant aortic isthmus obstruction. Surgical removal led to a normal aortogram within six years, suggesting an atheromatous origin.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Pathology
Background:
- Aortic thrombus formation can lead to significant vascular obstruction and clinical complications.
- Atherosclerosis is a common underlying pathology in cardiovascular diseases.
- Understanding the etiology of aortic thrombi is crucial for effective management.
Observation:
- A 52-year-old male presented with a large (5 cm) calcified thrombus obstructing two-thirds of the aortic isthmus lumen.
- Intraoperative findings revealed the thrombus originated from a small (4 mm) ulcerated plaque in the aortic wall.
Findings:
- The patient underwent surgical intervention for the aortic thrombus.
- Post-operative aortograms performed six years after surgery showed a normal aorta.
Implications:
- This case suggests that aortic thrombi, even large ones, can have an atheromatous origin.
- Successful surgical management can lead to long-term normalization of aortic anatomy.
- Atheromatous aortic plaques should be considered in the differential diagnosis of aortic thrombus formation.
Abstract:
A 52-year-old man presented with a calcified thrombus measuring 5 cm in length, which was responsible for obstruction of two-thirds of the aortic isthmus lumen. At operation the thrombus was seen to stem from an ulcerated plaque in the aortic wall, 4 mm in diameter. Six years later, his aortograms were normal. We believe the thrombus had an atheromatous origin.