Skip to main content
Journal cover image

Atypical aortic thrombus: should nonoperative management be first line?

Publication ,  Journal Article
Turley, RS; Unger, J; Cox, MW; Lawson, J; McCann, RL; Shortell, CK
Published in: Ann Vasc Surg
October 2014

BACKGROUND: Aortic thrombus in the absence of atherosclerotic plaque or aneurysm is rare, and its optimal management remains unclear. Although atypical aortic thrombus (AAT) has been historically managed operatively, successful nonoperative strategies have been recently reported. Here, we report our experience in treating patients with AAT that has evolved from a primarily operative approach to a first-line, nonoperative strategy. METHODS: Records of patients treated for AAT between 2008 and 2011 at our institution were reviewed. RESULTS: Ten female and three male patients with ages ranging from 27 to 69 were identified. Seven were treated operatively and 6 nonoperatively. Initial presentation was variable and included limb thromboembolic events (n = 6), visceral ischemia (n = 5), and stroke (n = 1). Associated risk factors included hypercoagulability (76%; n = 10) and hyperlipidemia (38%, n = 5). In the nonoperative group, complete thrombus resolution was obtained via anticoagulation (n = 5) or systemic thrombolysis (n = 1). Complete thrombus extraction was achieved in all operative patients. There were 11 significant complications in 5 of the 7 patients (71%) in the operative group, including intraoperative lower extremity embolism, pericardial effusion, stroke, and 1 death. There was 1 complication in the patients treated nonoperatively. The median hospital length of stay was 9 days (range 3-49) for those treated nonoperatively and 30 days (range 4-115) for those undergoing operative thrombectomy. CONCLUSIONS: Although AAT has traditionally been treated operatively, nonoperative management of AAT with anticoagulation or thrombolysis is feasible in selected patients and may lessen morbidity and length of hospitalization in those patients for whom it is appropriate.

Duke Scholars

Published In

Ann Vasc Surg

DOI

EISSN

1615-5947

Publication Date

October 2014

Volume

28

Issue

7

Start / End Page

1610 / 1617

Location

Netherlands

Related Subject Headings

  • Vascular Surgical Procedures
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Thrombosis
  • Thrombectomy
  • Risk Factors
  • Postoperative Complications
  • Middle Aged
  • Male
  • Length of Stay
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Turley, R. S., Unger, J., Cox, M. W., Lawson, J., McCann, R. L., & Shortell, C. K. (2014). Atypical aortic thrombus: should nonoperative management be first line? Ann Vasc Surg, 28(7), 1610–1617. https://doi.org/10.1016/j.avsg.2014.03.028
Turley, Ryan S., Joshua Unger, Mitchell W. Cox, Jeffrey Lawson, Richard L. McCann, and Cynthia K. Shortell. “Atypical aortic thrombus: should nonoperative management be first line?Ann Vasc Surg 28, no. 7 (October 2014): 1610–17. https://doi.org/10.1016/j.avsg.2014.03.028.
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 Oct;28(7):1610–7.
Turley, Ryan S., et al. “Atypical aortic thrombus: should nonoperative management be first line?Ann Vasc Surg, vol. 28, no. 7, Oct. 2014, pp. 1610–17. Pubmed, doi:10.1016/j.avsg.2014.03.028.
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 Oct;28(7):1610–1617.
Journal cover image

Published In

Ann Vasc Surg

DOI

EISSN

1615-5947

Publication Date

October 2014

Volume

28

Issue

7

Start / End Page

1610 / 1617

Location

Netherlands

Related Subject Headings

  • Vascular Surgical Procedures
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Thrombosis
  • Thrombectomy
  • Risk Factors
  • Postoperative Complications
  • Middle Aged
  • Male
  • Length of Stay