Endovascular stent graft repair of thoracic aortic mural thrombus in a patient with polycythemia vera: a word of caution

Vascular. 2015 Feb;23(1):89-92. doi: 10.1177/1708538114525154. Epub 2014 Feb 25.

Abstract

Thoracic aortic mural thrombus (TAMT) is a rare pathology and potential source of cerebral, visceral, and peripheral emboli. We present a 62-year-old male in a hypercoagulable state due to primary polycythemia vera (PV) developed TAMT and catastrophic thromboembolisms despite aggressive medical and surgical management. The outcomes and adverse events of endovascular exclusion of TAMT in the presence of PV are unknown. We would recommend proceeding with extreme caution when performing endovascular exclusion of TAMT, as PV may be a prohibitive risk.

Keywords: Thoracic aortic mural thrombus; endovascular aortic repair; polycythemia vera.

Publication types

  • Case Reports

MeSH terms

  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery*
  • Aortic Diseases / blood
  • Aortic Diseases / complications
  • Aortic Diseases / diagnosis
  • Aortic Diseases / surgery*
  • Aortography / methods
  • Blood Coagulation
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Echocardiography, Transesophageal
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / instrumentation
  • Humans
  • Male
  • Middle Aged
  • Polycythemia Vera / blood
  • Polycythemia Vera / complications*
  • Polycythemia Vera / diagnosis
  • Risk Assessment
  • Risk Factors
  • Thromboembolism / blood
  • Thromboembolism / etiology*
  • Thrombosis / blood
  • Thrombosis / complications
  • Thrombosis / diagnosis
  • Thrombosis / surgery*
  • Tomography, X-Ray Computed
  • Treatment Outcome