Key result
Femoropopliteal thromboembolectomy and subsequent anticoagulation successfully restored blood flow in a patient with acute lower-limb ischemia caused by a floating aortic thrombus.
Why the study?
The mechanism of aortic floating thrombosis is complex, and standardized treatment protocols or clinical guidelines are lacking.
Case Report (n=1)
Floating aortic thrombus is a rare but complex cause of acute limb ischemia that can be managed with thromboembolectomy and anticoagulation depending on patient condition.
May support thromboembolectomy plus anticoagulation in select cases of floating aortic thrombus; leaves open need for prospective data.
This report presents a patient with rheumatoid arthritis and COVID-19 infection one month earlier who experienced embolic episodes resulting in acute lower-limb ischemia from an unusual source. The blood flow was successfully restored by femoropopliteal thromboembolectomy. In determining the source of the embolism, the patient underwent electrocardiogram, transthoracic echocardiogram, and aortic CTA. The latter revealed a large, pedunculated, and mobile thrombus arising from the aortic arch and the descending thoracic aorta. Considering the patient's general health condition, we performed anticoagulation of the floating thrombus in the aortic lumen. The mechanism of aortic floating thrombosis exhibits considerable complexity. There are no standardized treatment protocols or clinical guidelines, and its treatment mainly includes open surgery, aortic endoluminal stent -graft insertion and pharmacological anticoagulation. Treatment strategy should be based on the cause of the disease and the patient's physical condition.
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Guo et al. (2023) conducted a case report in Acute limb ischemia caused by floating thrombus in the aorta (n=1). Femoropopliteal thromboembolectomy and anticoagulation was evaluated on Restoration of blood flow. Femoropopliteal thromboembolectomy and subsequent anticoagulation successfully restored blood flow in a patient with acute lower-limb ischemia caused by a floating aortic thrombus.
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