Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202200282
Jornal Vascular Brasileiro
Review Article

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

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Abstract

Abstract: A primary aortic mural thrombus (PAMT) is defined as a thrombus attached to the aortic wall in the absence of any atherosclerotic or aneurysmal disease of the aorta or any cardiac source of embolus. It is a rare entity that has high morbidity and mortality. There is no consensus on the ideal treatment of PAMT. The objective of this paper is to review the possibilities for treatment of mobile abdominal aortic mural thrombus. Endovascular therapy and open surgery appear to be the best options for treatment of mobile abdominal aortic mural thrombus. Thus, in patients with favorable anatomy, endovascular therapy is probably the treatment choice, while in those with unfavorable anatomy, open surgery is probably the best option for treatment of a mobile abdominal aortic thrombus. It is important to emphasize that anticoagulation alone can be used as a non-aggressive option and, if this fails, endovascular or surgical methods can then be employed.

Keywords

abdominal aortic mural thrombus, mural thrombi, aortic mobile thrombus, primary aortic mural thrombus, endovascular therapy

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

trombo aórtico abdominal, trombo móvel aórtico, trombo mural primário, terapia endovascular, aorta abdominal

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Submitted date:
02/24/2022

Accepted date:
06/27/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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