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Elective stent-graft treatment for the management of thoracic aorta mural thrombus

M Boufi1, A Mameli1, P Compes1

  • 1Université de la Méditerranée, Department of Vascular Surgery, University Hospital Nord, Marseille, France.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|February 4, 2014
PubMed

Insights

Stent-graft treatment is effective for thoracic aorta mural thrombus (AMT), especially for mobile thrombi. Evaluating thrombus mobility aids in selecting patients for intervention, improving outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Medicine
  • Interventional Radiology

Background:

  • Management of aorta mural thrombus (AMT) in the thoracic aorta remains controversial.
  • Identifying optimal treatment strategies and patient selection criteria for AMT is crucial.

Purpose of the Study:

  • To describe the management of thoracic AMT using conservative or stent-graft approaches.
  • To analyze morphological thrombus characteristics for guiding intervention selection.

Main Methods:

  • Retrospective review of 13 patients with thoracic AMT (2006-2013).
  • Comparison of clinical data, treatments (conservative vs. stent-graft), and outcomes.
  • Analysis of thrombus morphology (size, aspect, mobility) in relation to treatment and outcomes.

Main Results:

  • 13 patients (9 male, mean age 53) treated for symptomatic (n=8) or asymptomatic (n=5) AMT.
  • Stent-graft used in 7 patients, thrombectomy in 1, anticoagulation alone in 5.
  • High thrombus mobility was significantly associated with adverse outcomes (p=.048).
  • Endovascular exclusion of AMT was successful with no 30-day complications or deaths and no midterm recurrence.

Conclusions:

  • Stent-graft exclusion of AMT is an effective treatment approach.
  • Systematic evaluation of thrombus mobility via real-time imaging aids in defining indications for radical treatment.
Abstract

Keywords:
Aortic mural thrombusStentgraftThoracic aorta

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