Key result
Therapeutic anticoagulation alone achieves complete thrombus resolution in neonatal symptomatic aortic thrombosis.
Why the study?
Symptomatic aortic thrombosis in preterm neonates is a devastating condition with limited data on management and outcomes.
Case Report (n=1)
Therapeutic anticoagulation alone, without thrombolysis, can lead to complete thrombus resolution in preterm neonates with symptomatic aortic thrombosis.
May support conservative management of neonatal aortic thrombosis when thrombolysis is declined; leaves open need for prospective validation.
Symptomatic aortic thrombosis is a devastating condition in the neonatal intensive care unit (NICU), which is now increasingly being diagnosed with the availability of bedside ultrasound. Early intervention can go a long way towards preventing adverse outcomes. In our case, a preterm, very low birth weight, growth-restricted baby developed aortic thrombosis with hypertensive emergency and later limb-threatening ischaemia, which usually requires thrombolysis. However, due to the parents' reservations, he was given only therapeutic anticoagulation (with closely monitored activated partial thromboplastin time targets), which resulted in complete thrombus resolution. A multidisciplinary team approach was followed, and early detection with frequent monitoring led us to a favourable outcome.
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Kukreja et al. (2023) conducted a case report in Symptomatic aortic thrombosis (n=1). Therapeutic anticoagulation was evaluated on Thrombus resolution. Therapeutic anticoagulation alone resulted in complete thrombus resolution in a preterm neonate with symptomatic aortic thrombosis and hypertensive emergency.
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