title: Thrombolysis to treat thrombi of the aortic arch.
abstract: Thoracic mobile aortic mural thrombus (TAMT) of the aortic arch is a rare condition. We report 3 cases of symptomatic TAMT treated with systemic alteplase (tissue plasminogen activator [t-PA]) thrombolysis. The first patient was symptomatic with repetitive thromboembolism to the left brachial artery. She was treated with repetitive thrombolysis after surgical embolectomy of the brachial artery. The second patient was symptomatic with splenic infarction and mesenteric ischemia. She was treated with a single cycle of systemic thrombolysis followed by ileocoecal resection. The third patient presented with a TAMT obstructing the left common carotid artery, causing ischemic stroke. After systemic thrombolysis, a reduction in thrombus size was documented; however, the patient died later, of acute heart failure, during the clinical course. On follow-up 6 months after the incidences, the 2 surviving patients were in good condition and free of thromboembolic events. We show that systemic thrombolytic therapy can be performed successfully in patients with TAMT.
authors.affiliation: Department of Thoracic, Cardiac and Vascular Surgery, University Hospital of Tübingen, Germany. krueger-tobias@web.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Krüger
authors.forename: Benjamin
authors.initials: B
authors.lastname: Liske
authors.forename: Sabine
authors.initials: S
authors.lastname: Ziemer
authors.forename: Stephan
authors.initials: S
authors.lastname: Lindemann
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ziemer
mesh_terms: D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome