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Related Experiment Videos

Primary aortic mural thrombus: presentation and treatment

T L Hahn1, M C Dalsing, A P Sawchuk

  • 1Department of Surgery, Peripheral Vascular Surgery Section, Indiana University School of Medicine, Indianapolis, IN.

Annals of Vascular Surgery
|January 8, 1999
PubMed
Summary

Primary aortic thrombus can cause acute limb ischemia. Prompt treatment with embolectomy and anticoagulation can save limbs and resolve thrombus, but long-term anticoagulation may be needed.

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Area of Science:

  • Vascular Surgery
  • Cardiology
  • Internal Medicine

Background:

  • Acute lower-limb ischemia can be caused by primary aortic thrombus.
  • Atherosclerosis is a common cause of aortic thrombus, but primary thrombus formation without atherosclerosis is less understood.

Observation:

  • A review of six patients with primary aortic thrombus causing acute lower-limb ischemia was conducted.
  • Patients presented with acute lower-limb emboli requiring surgical embolectomy.
  • Aortic thrombi were identified via angiography, CT, or MRI, often without associated atherosclerotic disease.

Findings:

  • Surgical embolectomy followed by systemic anticoagulation led to limb salvage and thrombus resolution in all cases.
  • Recurrent embolic events occurred in one patient due to warfarin cessation.

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  • Resolution of the underlying cause of thrombus formation was associated with successful long-term outcomes.
  • Implications:

    • Primary aortic thrombus is a treatable cause of acute limb ischemia.
    • Prompt surgical intervention and anticoagulation are crucial for limb salvage.
    • Understanding the etiology of primary aortic thrombus is essential for guiding long-term management and preventing recurrence.