Management of Complicated Case of Floating Aortic Thrombus, Case Presentation

Background: Floating aortic thrombus is infrequent diagnosis in our daily work, with no standard guidelines of treatment. We present a complicated case of floating aortic thrombus highlighting the management strategy and outcomes.

Materials and Methods: A 58-year-old male patient referred to our institute with acute mesenteric vascular occlusion, with septic shock, diagnosed as SMA thrombus, underwent exploration for SMA thrombectomy, and assessment of intestinal viabilty. Workup showed that he had two big floating aortic thrombus in the descending thoracic aorta that managed by endovascular covered stent after failure of anticoagulation.

Results: Patient underwent successful SMA thrombectomy with regain of blood supply to the intestine with no need for intestinal resection, and improvement of general condition, therapeutic anticoagulation failed to stabilize the aortic thrombus as he got second attack of peripheral embolization to the left lower limb. Successful exclusion of the floating aortic thrombus by covered stent graft and femoral embolectomy with good short and midterm results.

Conclusion: Floating aortic thrombus is serious condition that need individualization of management according to the presentation. Endovascular treatment is a good option for cases showed recurrent embolization despite of therapeutic anticoagulation.

Publikationsverlauf

Artikel online veröffentlicht:
14. Dezember 2021