Key result
Emergency ascending aortic thrombectomy resolves acute aortic thrombosis following cisplatin chemotherapy with no 1-year recurrence.
Why the study?
Malignant tumors and chemotherapy increase the risk of thrombus development, but thrombosis of the ascending aorta is rare and treatment strategies are not well established.
Case Report (n=1)
No
Surgical thrombectomy can be a successful and safe treatment for acute ascending aortic thrombosis following cisplatin-based chemotherapy.
May signal rare aortic thrombosis risk during neoadjuvant chemotherapy in esophageal cancer; leaves open need for prospective studies on screening or prophylaxis.
BACKGROUND: The risk of thrombus development is considered to be increased by malignant tumors and chemotherapy. In addition, thrombosis of the ascending aorta is rare. We report a case of ascending aortic thrombectomy in a patient with esophageal cancer who developed ascending aortic thrombus after starting neoadjuvant chemotherapy, including operative findings and surgical treatment. CASE PRESENTATION: A 63-year-old man with esophageal cancer was administered chemotherapy comprising cisplatin plus 5-fluorouracil. A week after completing 1 cycle of chemotherapy, computed tomography angiography showed acute aortic thrombosis at the ascending aorta. The risk of embolization appeared high because the thrombosis was floating, so we performed emergency ascending aortic thrombectomy. The postoperative course was good and uncomplicated. A month after this surgery, the patient underwent surgery for esophageal cancer. As of 1 year after the cancer surgery, neither cancer nor thrombosis has recurred. CONCLUSION: We describe a case of acute aortic thrombosis in the ascending aorta after cisplatin-based chemotherapy, that was treated by aortic thrombectomy. The treatment strategy should depend on thrombus location and the condition of the patient, but surgical treatment should be considered where possible to achieve better prognosis.
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Sato et al. (2022) conducted a case report in Esophageal cancer and acute aortic thrombosis (n=1). Emergency ascending aortic thrombectomy was evaluated on Postoperative course and recurrence of thrombosis or cancer. Emergency ascending aortic thrombectomy successfully treated acute aortic thrombosis that developed after cisplatin-based chemotherapy in a 63-year-old man, with no recurrence at 1 year.
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