title: Floating aortic arch thrombus involving the supraaortic trunks: successful treatment with supra-aortic debranching and antegrade endograft implantation.
abstract: A floating thrombus within the aortic arch is a rare condition that is generally detected after cerebral, visceral, or peripheral embolization. Endovascular exclusion of such mobile thrombus has been described but exclusively involved the descending aorta, or debranching of the supra-aortic trunk was done by open surgical bypass procedure. We present a case with a floating thrombus that extended throughout the whole aortic arch and involved all of the supra-aortic trunks. The pathology was treated by debranching the supra-aortic trunks using a new nonsutured Viabahn-based (W. L. Gore & Associates, Flagstaff, Ariz) technique (Viabahn Open Revascularization TEChnique [VORTEC]) for revascularization of the left common carotid artery and performing an antegrade endograft implantation from the ascending aorta, distal to the origin of the feeding graft for debranching, to the descending aorta in one procedure.
authors.affiliation: Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland. zoran.rancic@usz.ch
authors.forename: Zoran
authors.initials: Z
authors.lastname: Rancic
authors.forename: Thomas
authors.initials: T
authors.lastname: Pfammatter
authors.forename: Mario
authors.initials: M
authors.lastname: Lachat
authors.forename: Thomas
authors.initials: T
authors.lastname: Frauenfelder
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Veith
authors.forename: Dieter
authors.initials: D
authors.lastname: Mayer
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001706:Biopsy; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D015607:Stents; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D011138:Polytetrafluoroethylene