Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Jul-Aug;17(4):283-296.
doi: 10.1177/15569845221107011. Epub 2022 Jul 21.

Management Strategies for Descending Thoracic Aortic Thrombus: A Review of the Literature

Quynh Nguyen  1 , Xiya Ma  2 , Dominique Vervoort  3 , Jessica G Y Luc  4
Affiliations
Review

Management Strategies for Descending Thoracic Aortic Thrombus: A Review of the Literature

Quynh Nguyen et al. Innovations (Phila). 2022 Jul-Aug.

Abstract

Descending thoracic aortic thrombus (DTAT) is an under-recognized source of systemic emboli with potential catastrophic consequences. Imaging modalities such as echocardiography, computed tomography, magnetic resonance imaging, and angiography can help identify and characterize the extent of embolic events. Established guidelines regarding the management of DTAT are currently lacking. Multiple treatment modalities are available; however, the effectiveness of each approach remains to be determined. In this study, we performed a review to examine the clinical presentation, diagnostic methods and findings, and outcomes of various treatment options for patients with DTAT. Medical management is the least invasive and most frequently chosen initial approach, offering a high reported success rate, whereas endovascular therapy can have a role in thrombus exclusion should conservative management fail.

Keywords: aortic thrombus; descending aortic thrombus; floating thrombus; mural thrombus.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1.
Fig. 1.
Proposed algorithm for the management of descending thoracic aortic thrombus. TEVAR, thoracic endovascular aortic repair.
See this image and copyright information in PMC

References

    1. Meyermann K, Trani J, Caputo FJ, et al. Descending thoracic aortic mural thrombus presentation and treatment strategies. J Vasc Surg 2017; 66: 931–936. - PubMed
    1. Yagyu T, Naito M, Kumada M, et al. Aortic mural thrombus in the non-atherosclerotic aorta of patients with multiple hypercoagulable factors. Intern Med 2019; 58: 381–385. - PMC - PubMed
    1. Kim JH, Jeon YS, Cho SG. Successful management of four unusual cases of acute aortic thrombus induced by chemotherapy. Clin Imaging 2016; 40: 224–227. - PubMed
    1. Abissegue YG, Lyazidi Y, Chtata H, et al. Acute systemic embolism due to an idiopathic floating thrombus of the thoracic aorta: success of medical management: a case report. BMC Res Notes 2015; 8: 1–5. - PMC - PubMed
    1. Fukuhara S, Tyagi S, Clarke-Pearson E, et al. Endovascular stent graft repair of thoracic aortic mural thrombus in a patient with polycythemia vera: a word of caution. Vascular 2015; 23: 89–92. - PubMed