Floating aortic arch thrombus involving the supraaortic trunks: successful treatment with supra-aortic debranching and antegrade endograft implantation.
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.
Rancic
Zoran
Z
Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland. zoran.rancic@usz.ch
Pfammatter
Thomas
T
Lachat
Mario
M
Frauenfelder
Thomas
T
Veith
Frank J
FJ
Mayer
Dieter
D
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
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D011138:Polytetrafluoroethylene