Successful Thromboaspiration of Occlusive Thrombus in Stenotic, Congenitally Duplicated Descending Thoracic Aorta

Acute thrombotic occlusion of the descending thoracic aorta (DTA) is a rare, and often fatal, event. Thromboaspiration represents a novel approach to this complication.

We present a 42-year-old woman with a history of congenitally duplicated DTA, previously treated with an interposition graft in the setting of iatrogenic dissection, who presented with a ruptured intracranial aneurysm. Following neuro-endovascular intervention via femoral arterial access, the patient developed anuria and lower-extremity mottling; she was found to have acute thrombosis of her previously placed DTA graft. She was successfully treated with thromboaspiration, angioplasty, and stenting.

This report illustrates a late complication of a rare congenital aortic abnormality; to our knowledge, this is the first reported case of successful endovascular thromboaspiration of occlusive DTA thrombus.

Thromboaspiration represents a viable option to manage acute DTA graft thrombosis.