title: Management of acute aortic thrombosis.
abstract: Acute aortic thrombosis (AAT) is a rare life threatening event that leads to a sudden occlusion of the aorta. The mortality and morbidity of AAT is still high despite modern surgical techniques. Usually it is the result of a large saddle embolus to the aortic bifurcation, in situ thrombosis of an atherosclerotic aorta or acute occlusion of an abdominal aortic aneurysm. Clinical symptoms depend on the level of the aortic occlusion and can be mistaken for a stroke or similar neurological disease. The combination of age and advanced cardiac disease seems to be significant risks factors for AAT. In patients who have no cardiac or vascular disease this catastrophic event is very rare and is mostly due to hypercoagulable disorders. Revascularization of the ischemic organ/limb as soon as possible is the major aim in the therapy of AAT to avoid further ischemic damage. Surgical reperfusion is the first line approach. If the accepting clinic has no facilities for an immediate surgical intervention it is of primary importance that these patients should be referred to an appropriate center for further management. Paradox seems the fact that most of the patients die as a consequence of reperfusion injury/postperfusion syndrome that occurs after revascularization of acute ischemic limbs.
authors.affiliation: Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany - m.kaschwich@uke.de.
authors.forename: Mark
authors.initials: M
authors.lastname: Kaschwich
authors.affiliation: Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Behrendt
authors.affiliation: Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimparis
authors.affiliation: Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
authors.affiliation: Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: Sabine H
authors.initials: SH
authors.lastname: Wipper
authors.affiliation: Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: Eike S
authors.initials: ES
authors.lastname: Debus
mesh_terms: D000208:Acute Disease; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D000072226:Computed Tomography Angiography; D006801:Humans; D015427:Reperfusion Injury / Q000209:etiology / Q000401:mortality; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects / Q000401:mortality; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D014654:Vascular Patency