Key result
Simple anticoagulation shows similar rates of embolism recurrence or exacerbation compared to surgical treatment.
Why the study?
Aortic mural thrombosis associated with malignant disease is rare, and the optimal primary treatment between anticoagulation therapy and surgical treatment remains uncertain.
Does simple anticoagulation therapy prevent recurrence or exacerbation of embolism as effectively as surgical treatment in patients with aortic thrombosis associated with a malignant disease?
Does simple anticoagulation therapy prevent recurrence or exacerbation of embolism as effectively as surgical treatment in patients with aortic thrombosis associated with a malignant disease?
Absolute Event Rate: 15.4% vs 20%
p-value: p=1.0
Simple anticoagulation therapy may be as effective as surgical treatment for managing aortic thrombosis in patients with malignancy.
Optimal management of aortic mural thrombosis in malignancy remains uncertain; leaves open whether anticoagulation or surgery is preferable pending higher-level evidence.
INTRODUCTION:: Aortic mural thrombosis associated with a malignant disease is rare, and whether anticoagulation therapy or surgical treatment is the more definitive primary treatment remains uncertain. This study aims to determine the best treatment strategy for aortic thrombosis in a patient with a malignant disease. METHODS:: We reviewed medical literature using the PubMed database and present a case of aortic thrombosis due to a hypercoagulable state related to sigmoid colon adenocarcinoma. RESULTS:: Of the 18 patients from 14 articles included in this study, 13 received simple anticoagulation as a primary treatment (anticoagulation group), while 5 underwent surgical treatment (surgical treatment group). Recurrence or exacerbation of embolism was found in 2 (15.4%) of the 13 patients and in 1 (20.0%) of the 5 patients ( P = 1.0). Major complications were observed in 1 (7.7%) of the patients in the anticoagulation group and in 1 (20.0%) of the 5 patients in the surgical treatment group ( P = .49). No significant differences between the groups were found. CONCLUSIONS:: A simple anticoagulation therapy may be as effective as surgical treatment in patients with aortic thrombosis associated with malignancy.
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Arima et al. (2018) conducted a review in Aortic thrombosis associated with malignant disease (n=18). Simple anticoagulation vs. Surgical treatment was evaluated on Recurrence or exacerbation of embolism (p=1.0). Simple anticoagulation therapy was associated with similar rates of recurrence or exacerbation of embolism compared to surgical treatment (15.4% vs 20.0%; P=1.0).
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