title: Acute left arm ischemia associated with floating thrombus in the proximal descending aorta: combined endovascular and surgical therapy.
abstract: Free floating thrombus in the proximal descending aorta is an uncommon and dangerous condition that can be associated with acute peripheral embolization. The few cases described were solved with surgical and/or medical therapy. We report the case of a patient with acute left arm ischemia secondary to the presence of floating thrombus in the proximal descending aorta extending into the left subclavian artery, solved with combined endovascular and surgical therapy. Treatment was successfully performed with thrombembolectomy combined with temporary deployment, into the descending aorta, of a Wallstent in a "basket-fashion" to avoid distal embolization secondary to thrombus fragmentation. At 1 year follow-up the patient remained symptom-free.
authors.affiliation: Department of Radiological Sciences, Interventional Radiology Unit, Sapienza-University of Rome, 324-Viale Regina Elena, 00161, Rome, Italy. fabrizio.fanelli@uniroma1.it
authors.forename: F
authors.initials: F
authors.lastname: Fanelli
authors.forename: M
authors.initials: M
authors.lastname: Gazzetti
authors.forename: E
authors.initials: E
authors.lastname: Boatta
authors.forename: M
authors.initials: M
authors.lastname: Ruggiero
authors.forename: P
authors.initials: P
authors.lastname: Lucatelli
authors.forename: F
authors.initials: F
authors.lastname: Speziale
mesh_terms: D000208:Acute Disease; D000368:Aged; D000792:Angiography; D000925:Anticoagulants / Q000008:administration & dosage; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications* / Q000628:therapy*; D001132:Arm / Q000098:blood supply*; D017548:Echocardiography, Transesophageal; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000628:therapy*; D008297:Male; D012307:Risk Factors; D015607:Stents; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000150:complications* / Q000628:therapy*; D014057:Tomography, X-Ray Computed
chemical_list: D000925:Anticoagulants; D006493:Heparin