Document Detail


Staged endovascular stent grafts for concurrent mobile/ulcerated thrombi of thoracic and abdominal aorta causing recurrent spontaneous distal embolization.
MedLine Citation:
PMID:  18178473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mobile thrombus of the thoracic aorta is an uncommon pathology with potentially catastrophic complications. Recurrent spontaneous distal embolization may also occur from an ulcerated thrombus of the abdominal aorta. The simultaneous presence of a mobile thrombus in the thoracic aorta and ulcerated thrombus of the abdominal aorta is extremely rare and poses a significant treatment dilemma. Although various approaches have been reported, there is no standard treatment. Direct replacement of the thoracoabdominal aorta is extremely morbid, while continued embolization despite anticoagulation mandate intervention. We herein present the first case report of successful treatment of symptomatic mobile/ulcerated thrombi of the thoracic and abdominal aorta using staged endovascular stent graft repair. Successful treatment of the thoracic component with a thoracic aortic graft (TAG, Gore-Tex, W. L. Gore & Assoc., Flagstaff, Ariz.) was followed one week later by exclusion of the infrarenal aortic lesion with a bifurcated stent graft. Endovascular stent graft exclusion of mobile/ulcerated thoracic and abdominal aortic thrombi is a minimal invasive operation. It can be employed as an alternative procedure in treatment of aortic thrombus with embolization in high risk patients. Long-term follow-up will be necessary to assess the durability of this technique.
Authors:
Wayne W Zhang; Ahmed M Abou-Zamzam; Mazen Hashisho; J David Killeen; Christian Bianchi; Theodore H Teruya
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  47     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-02-28     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  193-6     Citation Subset:  IM    
Affiliation:
Division of Vascular Surgery, Department of Surgery, Loma Linda University School of Medicine, 11175 Campus Street, Loma Linda, CA 92350, USA. wwzhang@ahs.llumc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta, Abdominal / pathology,  surgery*
Aorta, Thoracic / pathology,  surgery*
Aortic Diseases / complications,  pathology,  surgery*
Aortography / methods
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / instrumentation*,  methods
Embolism / etiology*,  pathology,  surgery
Humans
Male
Prosthesis Design
Recurrence
Stents*
Surgical Procedures, Minimally Invasive / instrumentation
Thrombosis / complications,  pathology,  surgery*
Tomography, X-Ray Computed
Treatment Outcome
Ulcer / complications,  pathology,  surgery*
Ultrasonography, Interventional

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