Massive organ embolization from primary aortic thrombosis

Publication date: May 2018Source: Revista Portuguesa de Cardiologia (English Edition), Volume 37, Issue 5Author(s): Catarina Patrício, Mariana Marques Silva, Pedro Eduardo Silva, João Oliveira, Luís BagulhoAbstractA 49-year-old woman was hospitalized for acute left foot arterial ischemia. Arterial Doppler revealed occlusion of the dorsalis pedis and posterior tibial arteries. A computed tomography angiography performed to assess abdominal pain showed hepatic, splenic, renal and pancreatic infarctions. A splenic artery embolism and a small aortic wall thrombus at the celiac trunk were identified. No radiological signs of aortic atherosclerosis were found. No predisposing conditions for secondary aortic thrombosis or intracardiac embolic sources were detected. It was determined that primary aortic thrombosis, a rare though potentially serious condition, was to blame. Isolated aortic mural thrombosis therapy is not well established, although systemic anticoagulation, thrombolysis, thromboaspiration, endovascular stent grafting and surgical thrombectomy have been attempted with varying success. In our patient, systemic anticoagulation therapy was initiated and resulted in aortic thrombus resolution. Close clinical follow-up is crucial, as the aortic thrombus can recur despite anticoagulation and aggressive control of the atherosclerotic risk factors.ResumoDoente de 49 anos do sexo feminino, admitida por isquemia aguda do pé esquerdo. O Doppler arterial revelou oclusão das ar...

Source: Revista Portuguesa de Cardiologia - July 10, 2018 Category: Cardiology Source Type: research