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Review
. 2022 Aug 27;14(8):e28481.
doi: 10.7759/cureus.28481. eCollection 2022 Aug.

A Proposed Approach for the Management of Clot-in-Transit

Aayushi N Patel  1 , Rahulkumar J Amrutiya  2 , Buddhadev N Manvar  3
Affiliations
Review

A Proposed Approach for the Management of Clot-in-Transit

Aayushi N Patel et al. Cureus. .

Abstract

Clot-in-transit (CIT) is defined as a mobile echogenic material in the right atrium or ventricle as observed on ultrasound. A right heart free-floating thrombus is unusual when there is no structural disease of the heart or atrial fibrillation. Cardiopulmonary collapse and quick death can come from CIT, which occurs when a blood clot moves from the heart to the lungs. There are some clinical case reports of a large volume thrombus that was freely floating in the right heart in an asymptomatic patient, and the best therapeutic options are uncertain. Although several trials have been conducted on the treatment of CIT, clinical judgment is still used to determine the best treatment for right heart thrombus (RHT), especially when associated with pulmonary embolism (PE). In this review article, we discuss various diagnostic modalities and treatment options for this rare malady. We studied in detail their clinical impact on patients according to past research studies.

Keywords: angiovac system; anticoagulant therapy; catheter-directed thrombolysis; clot in transit; free floating right heart thrombus; point of care ultrasound (pocus); pulmonary embolism (pe); right heart clot; surgical thrombectomy (st); thrombus in transit.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Suggested algorithm for the treatment of clot-in-transit
Resource-rich setting: An operating room with cardiopulmonary bypass setup and experienced surgeon available round-the-clock.
See this image and copyright information in PMC

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