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Clin Appl Thromb Hemost. 2011 Aug;17(4):340-5. doi: 10.1177/1076029610364519. Epub 2010 May 11.

Thrombolysis to treat thrombi of the aortic arch.

Author information

1
Department of Thoracic, Cardiac and Vascular Surgery, University Hospital of Tübingen, Germany. krueger-tobias@web.de

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.

PMID:
20460343
DOI:
10.1177/1076029610364519
[Indexed for MEDLINE]

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