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Updated: Aug 8, 2026
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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Primary Aortic Mural Thrombus: Clinical Presentation, Embolization Patterns, and Early Outcomes in a Consecutive
Yonghui Wang1, Yan Wang1, Weihao Li1
1Department of Vascular Surgery, Peking University People's Hospital, Beijing, China.
Annals of Vascular Surgery
|August 6, 2026
Summary
Primary aortic mural thrombus (PAMT) often causes lower limb ischemia. Most PAMT cases resolved or regressed with treatment, showing low rates of recurrent embolization.
Area of Science:
- Vascular Surgery
- Cardiovascular Imaging
- Interventional Cardiology
Background:
- Primary aortic mural thrombus (PAMT) is a rare cause of systemic arterial embolization.
- Understanding PAMT's clinical features and outcomes is crucial for patient management.
Purpose of the Study:
- To describe the clinical presentation, anatomical distribution, and treatment strategies for PAMT.
- To evaluate early outcomes, including embolization recurrence and mortality, in PAMT patients.
Main Methods:
- Retrospective review of 23 patients diagnosed with PAMT between 2018 and 2024.
- PAMT defined by CT angiography, excluding aneurysm, dissection, or significant atherosclerosis.
- Analysis of clinical data, thrombus location, embolization patterns, treatments, and follow-up outcomes.
Main Results:
- Acute lower limb ischemia was the most common presentation (17/23 patients).
- Infrarenal abdominal aorta was the most frequent thrombus location, with iliac/lower extremity embolization predominating.
- Thrombus regression/resolution occurred in 18 patients; 3 experienced recurrent embolization; 90-day mortality was 8.7%.
Conclusions:
- PAMT commonly presents with lower limb ischemia and infrarenal aortic location.
- Embolization patterns may correlate with thrombus location, requiring further investigation.
- Early outcomes are generally favorable, but further research is needed for optimal management.
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