Key result
Catheter-directed thrombolysis and open thrombectomy successfully resolve spontaneous aortic thrombus during cisplatin chemotherapy.
Why the study?
Spontaneous aortic thrombosis is exceedingly rare, and its optimal treatment remains uncertain.
Case Report (n=1)
No
A hybrid approach of catheter-directed thrombolysis followed by open aortic thrombectomy can be successfully used to manage rare spontaneous aortic thrombosis in patients undergoing cisplatin-based chemotherapy.
Answers are grounded in this paper and cite their sources.
Supports hybrid management of cisplatin-associated aortic thrombosis; hypothesis-generating and requires validation before broader adoption.
Spontaneous aortic thrombosis is exceedingly rare, and optimal treatment remains uncertain. We present an unusual case of a spontaneous aortic thrombus at the renal artery level in a patient undergoing active cisplatin treatment for urothelial carcinoma. Management included catheter-directed thrombolysis followed by thrombectomy. An open cutdown was performed on the left common femoral artery (CFA), with right groin access via a 6-Fr sheath. Clamping of the left superficial and deep femoral arteries, along with balloon occlusion of the right common iliac artery, prevented distal embolization. A Coda balloon introduced via direct left CFA puncture with a 20-Fr sheath was positioned above the aortic thrombus. After inflation, clots were trawled to the sheath, "sandwiching" the clots before removal of the balloon and sheath via the left groin. Post-operatively, the patient recovered well and received continued therapeutic anticoagulation.
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Zheng et al. (2023) conducted a case report in Spontaneous aortic thrombus and urothelial carcinoma (n=1). Catheter-directed thrombolysis and open aortic thrombectomy was evaluated on Thrombus resolution. A 58-year-old male with urothelial carcinoma developed a spontaneous aortic thrombus during cisplatin-based chemotherapy, which was successfully managed with catheter-directed thrombolysis and open aortic thrombectomy.
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