title: Endovascular treatment of massive thoracic aortic thrombus and associated ruptured atheroma.
abstract: Atheroembolic disease typically presents with isolated lower extremity digital ischemia. Treatment traditionally includes optimization of medical management, with open surgery reserved for complicated or recurrent embolic events. We present a novel endovascular approach for treatment of complicated thoracic aortic atherosclerotic disease incidentally discovered in a 63-year-old female. The patient demonstrated visceral artery embolization from a mobile 2.6 cm atherosclerotic plaque despite maximal medical therapy. Thoracic aortic stent graft placement successfully excluded the atheroma and prevented further embolization. This case demonstrates a unique treatment option for complicated thoracic aortic atheroembolic disease utilizing a minimally invasive endovascular approach.
authors.affiliation: Harborview Medical Center, University of Washington, Division of Vascular Surgery, Seattle, WA 98104, USA.
authors.forename: Patrick S
authors.initials: PS
authors.lastname: Wolf
authors.forename: H E Guy
authors.initials: HE
authors.lastname: Burman
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Starnes
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001019:Aortic Rupture / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D017548:Echocardiography, Transesophageal; D017700:Embolism, Cholesterol / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D012720:Severity of Illness Index; D015607:Stents; D013927:Thrombosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome