[MEP-28] Optimal Management of Thoracic Aortic Mobile Thrombus: Lessons From Clinical Cases

Area of Science:

• Cardiovascular Medicine
• Vascular Surgery
• Interventional Radiology

Background:

• Thoracic aortic mobile thrombus (TAMT) is a rare but serious condition, often diagnosed after embolic events.
• Advanced imaging aids early detection, but treatment algorithms remain undefined.
• TAMT can lead to severe complications like systemic embolization and organ failure.

Purpose of the Study:

• To discuss treatment options for thoracic aortic mobile thrombus.
• To present case studies of successful interventions for TAMT.
• To highlight the need for individualized treatment strategies.

Main Methods:

• Computed tomography angiography for diagnosis.
• Thoracic endovascular aortic repair for localized thrombus.
• Catheter-directed thrombolysis with alteplase for multiple thrombi.

Main Results:

• Successful exclusion of a large descending aortic thrombus with endovascular repair in one patient.
• Complete lysis of multiple aortic thrombi using thrombolysis in another patient.
• Both patients were discharged on anticoagulants with no embolic events or residual thrombi.

Conclusions:

• Treatment for TAMT must be individualized based on thrombus characteristics, patient condition, and available resources.
• Endovascular repair and thrombolysis are viable options for managing TAMT.
• Careful monitoring is essential during thrombolytic therapy to mitigate bleeding risks.