Endovascular treatment of massive thoracic aortic thrombus and associated ruptured atheroma.
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.
Wolf
Patrick S
PS
Harborview Medical Center, University of Washington, Division of Vascular Surgery, Seattle, WA 98104, USA.
Burman
H E Guy
HE
Starnes
Benjamin W
BW
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