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Floating aortic thrombus: the endovascular approach.

W-J Metsemakers¹, J Duchateau, F Vanhoenacker

¹Department of Thoracovascular Surgery, General Hospital, AZ. St. Maarten, Duffel, Belgium. willemjanmets@hotmail.com

Acta Chirurgica Belgica

|April 5, 2013

Summary

A rare case of floating thrombus in the abdominal aorta caused leg pain. Endovascular repair with a bare-metal stent successfully treated the condition, resolving symptoms.

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Area of Science:

Vascular Surgery
Interventional Radiology
Cardiovascular Medicine

Background:

Floating thrombus in the infrarenal abdominal aorta is a rare condition.
Distal arterial embolization can present with acute limb ischemia or claudication.

Observation:

A 71-year-old obese female presented with sudden right calf pain after a long flight, initially suspected as deep vein thrombosis.
Duplex ultrasound ruled out DVT; subsequent evaluation revealed right popliteal artery occlusion and a floating infrarenal abdominal aortic thrombus via CT angiography.

Findings:

Endovascular repair using a bare-metal stent via femoral approach successfully excluded the aortic thrombus.
Post-procedure CT scans at 1 and 3 months confirmed thrombus exclusion.
The patient's calf claudication resolved spontaneously post-intervention.

Implications:

CT angiography is the preferred diagnostic modality for infrarenal aortic thrombus.
Endovascular repair is an effective treatment for floating aortic thrombus causing distal embolization.
A covered stent is not essential, and anticoagulation should be individualized.