title: Transesophageal echo-guided endovascular exclusion of thoracic aortic mobile thrombi.
abstract: Mobile luminal thrombus of the descending thoracic aorta is an unusual finding in patients with peripheral embolization. The diagnosis is best made with transesophageal echography (TEE). Traditionally, systemic anticoagulation and selective surgical thrombectomy are standard treatment. We present a case report of recurrent mobile thrombus despite surgical thrombectomy and systemic anticoagulation. We treated it with endovascular exclusion of a descending thoracic aorta emboligenic lesion with an endoluminal stent graft, using simultaneous TEE and fluoroscopic intraoperative guidance. The patient remains symptom-free 9 months after stent-graft implantation. TEE-guided endoluminal exclusion should be considered in treatment of descending thoracic aorta emboligenic lesions.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Health Sciences Center T-19, Room 040, Stony Brook University, Stony Brook, NY 11794-8191, USA. ecriado@notes.cc.sunysb.edu
authors.forename: Enrique
authors.initials: E
authors.lastname: Criado
authors.forename: Phillip
authors.initials: P
authors.lastname: Wall
authors.forename: Paul
authors.initials: P
authors.lastname: Lucas
authors.forename: Antonios
authors.initials: A
authors.lastname: Gasparis
authors.forename: Trent
authors.initials: T
authors.lastname: Proffit
authors.forename: John
authors.initials: J
authors.lastname: Ricotta
mesh_terms: D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D015607:Stents; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*; D018084:Ultrasonography, Interventional