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Updated: May 14, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Bare metal stenting for endovascular exclusion of aortic arch thrombi
Andreas H Mahnken1, Andras Hoffman, Rüdiger Autschbach
1Department of Diagnostic Radiology, University Hospital Giessen and Marburg, Philipps University of Marburg, Baldingerstrasse, 35033, Marburg, Germany. mahnken@med.uni-marburg.de
Background:
Aortic thrombi in the ascending aorta or aortic arch are rare but are associated with a relevant risk of major stroke or distal embolization. Although stent grafting is commonly used as a treatment option in the descending aorta, only a few case reports discuss stenting of the aortic arch for the treatment of a thrombus. The use of bare metal stents in this setting has not yet been described.
Methods:
We report two cases of ascending and aortic arch thrombus that were treated by covering the thrombus with an uncovered stent. Both procedures were performed under local anesthesia via a femoral approach. A femoral cutdown was used in one case, and a total percutaneous insertion was possible in the second case.
Results:
Both procedures were successfully performed without any periprocedural complications. Postoperative recovery was uneventful. In both cases, no late complications or recurrent embolization occurred at midterm follow-up, and control CT angiography at 1 respectively 10 months revealed no stent migration, freely perfused supra-aortic branches, and no thrombus recurrence.
Conclusion:
Treating symptomatic thrombi in the ascending aorta or aortic arch with a bare metal stent is feasible. This technique could constitute a minimally invasive alternative to a surgical intervention or complex endovascular therapy with fenestrated or branched stent grafts.