Mobile thrombus of the abdominal aorta: a narrative review
Trombo móvel de aorta abdominal: uma revisão narrativa
Ana Paula Donadello Martins; Leonardo Henrique Bertolucci; Rodrigo Batista Warpechowski; Arthur Angonese; Mariana Saadi de Azevedo; Camilla Rodrigues; Alfredo Augusto Schulte; Silvio Cesar Perini
Abstract
Keywords
Resumo
Resumo: O trombo mural aórtico primário é definido como um trombo aderido à parede aórtica na ausência de doença aterosclerótica e/ou aneurismática ou de fonte cardíaca de êmbolo. Trata-se de uma doença rara, porém causadora de alta morbimortalidade, e não há consenso acerca do seu tratamento. Este estudo objetivou revisar as possibilidades na presença de componente móvel. A terapia endovascular e a cirurgia aberta parecem ser as melhores opções, sendo a abordagem endovascular o tratamento de escolha para pacientes com anatomia favorável e a cirurgia aberta o tratamento de escolha para pacientes com anatomia desfavorável. No entanto, a anticoagulação sistêmica apresenta-se como método não invasivo para pacientes com alto risco cirúrgico e como possibilidade terapêutica na falha ou indisponibilidade de abordagem cirúrgica.
Palavras-chave
References
1 Weismann RE, Tobin RW. Arterial embolism occurring during systemic heparin therapy. AMA Arch Surg. 1958;76(2):219-25, discussion 225-7.
2 Machleder HI, Takiff H, Lois JF, Holburt E. Aortic mural thrombus: an occult source of arterial thromboembolism. J Vasc Surg. 1986;4(5):473-8.
3 Williams GM, Harrington D, Burdick J, White RI. Mural thrombus of the aorta. Ann Surg. 1981;194(6):737-44.
4 Moris D, Karaolanis G, Schizas D, Georgopoulos S. eComment. Mural thrombus in normal appearing aorta: Unfinished saga in uncharted waters. Interact Cardiovasc Thorac Surg. 2016;22(3):373-4.
5 Varino J, Rodrigues R, Pereira B, Moreira M, Gonçalves Ó. Aortic mural thrombus. Rev Port Cir Cardiotorac Vasc. 2019;26(1):19-26. PMid:31104372.
6 Roche-Nagle G, Wooster D, Oreopoulos G. Symptomatic thoracic aorta mural thrombus. Vascular. 2010;18(1):41-4.
7 Tsilimparis N, Hanack U, Pisimisis G, Yousefi S, Wintzer C, Rückert RI. Thrombus in the non-aneurysmal, non-atherosclerotic descending thoracic aorta – an unusual source of arterial embolism. Eur J Vasc Endovasc Surg. 2011;41(4):450-7.
8 Turley RS, Unger J, Cox MW, Lawson J, McCann RL, Shortell CK. Atypical aortic thrombus: should nonoperative management be first line? Ann Vasc Surg. 2014;28(7):1610-7.
9 Fayad ZY, Semaan E, Fahoum B, Briggs M, Tortolani A, D’Ayala M. Aortic mural thrombus in the normal or minimally atherosclerotic aorta. Ann Vasc Surg. 2013;27(3):282-90.
10 Weiss S, Bühlmann R, von Allmen RS, et al. Management of floating thrombus in the aortic arch. J Thorac Cardiovasc Surg. 2016;152(3):810-7.
11 Meyermann K, Trani J, Caputo FJ, Lombardi JV. Descending thoracic aortic mural thrombus presentation and treatment strategies. J Vasc Surg. 2017;66(3):931-6.
12 Aldaher MK, El-Fayed HM, Malouka SA, Gad FS. Large aortic arch mural thrombus in non-atherosclerotic thoracic aorta--a rare cause of stroke in the young. BMJ Case Rep. 2015;2015(nov19 1):bcr2015212887.
13 Piffaretti G, Tozzi M, Caronno R, Castelli P. Endovascular treatment for mobile thrombus of the thoracic aorta. Eur J Cardiothorac Surg. 2007;32(4):664-6.
14 Verma H, Meda N, Vora S, George RK, Tripathi RK. Contemporary management of symptomatic primary aortic mural thrombus. J Vasc Surg. 2014;60(6):1524-34.
15 Boufi M, Mameli A, Compes P, Hartung O, Alimi YS. Elective stent-graft treatment for the management of thoracic aorta mural thrombus. J Vasc Surg. 2014;59(4):1177.
16 Yagyu T, Naito M, Kumada M, Nakagawa T. Aortic mural thrombus in the non-atherosclerotic aorta of patients with multiple hypercoagulable factors. Intern Med. 2019;58(3):381-5.
17 Laperche T, Laurian C, Roudaut R, Steg PG. Mobile thromboses of the aortic arch without aortic debris. Circulation. 1997;96(1):288-94.
18 Sabetai MM, Conway AM, Hallward G, Bapat V. Ascending aorta thrombus adjacent to a cholesterol-rich plaque as the source of multiple emboli. Interact Cardiovasc Thorac Surg. 2013;16(3):389-90.
19 Hahn TL, Dalsing MC, Sawchuk AP, Cikrit DF, Lalka SG. Primary aortic mural thrombus: presentation and treatment. Ann Vasc Surg. 1999;13(1):52-9.
20 Bowdish ME, Weaver FA, Liebman HA, Rowe VL, Hood DB. Anticoagulation is an effective treatment for aortic mural thrombi. J Vasc Surg. 2002;36(4):713-9.
21 Poirée S, Monnier-Cholley L, Tubiana J-M, Arrivé L. Acute abdominal aortic thrombosis in cancer patients. Abdom Imaging. 2004;29(4):511-3.
22 Caron F, Anand SS. Antithrombotic therapy in aortic diseases: a narrative review. Vasc Med. 2017;22(1):57-65.
23 Reyes Valdivia A, Duque Santos A, Garnica Ureña M, et al. Anticoagulation alone for aortic segment treatment in symptomatic primary aortic mural thrombus patients. Ann Vasc Surg. 2017;43:121-6.
24 Patrício C, Silva MM, Silva PE, Oliveira J, Bagulho L. Massive organ embolization from primary aortic thrombosis. Rev Port Cardiol. 2018;37(5):447.e1-6.
25 DeKornfeld GM, Boll J, Ziegler KR, et al. Initial and intermediate-term treatment of the phantom thrombus (primary non-occlusive mural thrombus on normal arteries). Vasc Med. 2018;23(6):549-54.
26 Reber PU, Patel AG, Stauffer E, Müller MF, Do DD, Kniemeyer HW. Mural aortic thrombi: an important cause of peripheral embolization. J Vasc Surg. 1999;30(6):1084-9.
27 Dougherty MJ, Calligaro KD, Rua I, Delaurentis DA. Idiopathic pedunculated mural thrombus of the nonaneurysmal infrarenal aorta presenting with popliteal embolization: two cases treated with thrombolytic therapy. J Vasc Surg. 2000;32(2):383-7.
28 Bosma J, Rijbroek A, Rauwerda JA. A rare case of thromboembolism in a 21-year old female with elevated factor VIII. Eur J Vasc Endovasc Surg. 2007;34(5):592-4.
29 Zhang WW, Abou-Zamzam AM, Hashisho M, Killeen JD, Bianchi C, Teruya TH. Staged endovascular stent grafts for concurrent mobile/ulcerated thrombi of thoracic and abdominal aorta causing recurrent spontaneous distal embolization. J Vasc Surg. 2008;47(1):193-6.
30 Luckeroth P, Steppacher R, Rohrer MJ, Eslami MH. Endovascular therapy for symptomatic mobile thrombus of infrarenal abdominal aorta. Vasc Endovascular Surg. 2009;43(5):518-23.
31 Kim WC, Hong KC, Kim JY, Cho SG, Jeon YS. Successful hybrid operation of an acute mobile thrombus in the abdominal aorta induced by chemotherapy. J Korean Surg Soc. 2011;81(Suppl 1):S78-81.
32 Kadoya Y, Zen K, Oda Y, Matoba S. Successful endovascular treatment for aortic thrombosis due to primary antiphospholipid syndrome: a case report and literature review. Vasc Endovascular Surg. 2019;53(1):51-7.
33 Murter CD, Sigdel A, Dwivedi AJ, Wayne EJ. Percutaneous thrombectomy of mural aortic thrombus using intravascular ultrasound guidance. J Vasc Surg Cases Innov Tech. 2019;5(4):472-6.
34 Borghese O, Pisani A, Di Centa I. Symptomatic aortic mural thrombus treatment and outcomes. Ann Vasc Surg. 2020;69:373-81.
35 Tunick PA, Kronzon I. Embolism from the aorta: atheroemboli and thromboemboli. Curr Treat Options Cardiovasc Med. 2001;3(3):181-6.
36 Saric M, Kronzon I. Aortic atherosclerosis and embolic events. Curr Cardiol Rep. 2012;14(3):342-9.
37 Mando R, Gemayel R, Chaddha A, Barbat JJ, Cami E. Peripherally embolizing aortic thrombus: the work-up, management, and outcome of primary aortic thrombus. Case Rep Cardiol. 2019;2019:8132578.
38 Jariwala P, Kale SS. Resolution of primary aortic thrombosis after dabigatran therapy-a new hope for the rare and old disease. Indian Heart J. 2019;71(2):166-9.
39 Luebke T, Aleksic M, Brunkwall J. Endovascular therapy of a symptomatic mobile thrombus of the thoracic aorta. Eur J Vasc Endovasc Surg. 2008;36(5):550-2.
40 Altenbernd J, Schürmann K, Walterbusch G. Stentgraft-therapie bei mobilem thrombus in der thorakalen aorta. RoFo Fortschr Geb Rontgenstr Nuklearmed. 2008;180(2):158-9.
41 Fueglistaler P, Wolff T, Guerke L, Stierli P, Eugster T. Endovascular stent graft for symptomatic mobile thrombus of the thoracic aorta. J Vasc Surg. 2005;42(4):781-3.
42 Rancic Z, Pfammatter T, Lachat M, Frauenfelder T, Veith FJ, Mayer D. Floating aortic arch thrombus involving the supraaortic trunks: Successful treatment with supra-aortic debranching and antegrade endograft implantation. J Vasc Surg. 2009;50(5):1177-80.
43 Jeyabalan G, Wallace JR, Chaer RA, Leers SA, Marone LK, Makaroun MS. Endovascular strategies for treatment of embolizing thoracoabdominal aortic lesions. J Vasc Surg. 2014;59(5):1256-64.
44 Tsilimparis N, Spanos K, Debus ES, Rohlffs F, Kölbel T. Technical aspects of using the angiovac system for thrombus aspiration from the ascending aorta. J Endovasc Ther. 2018;25(5):550-3.
45 Brickwedel J, Kölbel T, Rohlffs F, Detter C, Reichenspurner H, Tsilimparis N. Thrombus aspiration from the ascending aorta using the angiovac device: a case report. Thorac Cardiovasc Surg. 2017;65(S 01):S1-110.
46 Frisoli TM, So C-Y, Guruswamy JG, Chebl AB, Lee JC, Eng MH. Vacuuming in crowded dangerous spaces: aspiration of large ascending aortic thrombus. JACC Case Rep. 2020;2(12):1979-83. PMid:34317093.
Submitted date:
02/24/2022
Accepted date:
06/27/2022
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email