Criado Enrique, Wall Phillip, Lucas Paul, Gasparis Antonios, Proffit Trent, Ricotta John
Division of Vascular Surgery, Department of Surgery, Health Sciences Center T-19, Room 040, Stony Brook University, Stony Brook, NY 11794-8191, USA.
J Vasc Surg. 2004 Jan;39(1):238-42. doi: 10.1016/j.jvs.2003.07.017.
Mobile luminal thrombus of the descending thoracic aorta is an unusual finding in patients with peripheral embolization. The diagnosis is best made with transesophageal echography (TEE). Traditionally, systemic anticoagulation and selective surgical thrombectomy are standard treatment. We present a case report of recurrent mobile thrombus despite surgical thrombectomy and systemic anticoagulation. We treated it with endovascular exclusion of a descending thoracic aorta emboligenic lesion with an endoluminal stent graft, using simultaneous TEE and fluoroscopic intraoperative guidance. The patient remains symptom-free 9 months after stent-graft implantation. TEE-guided endoluminal exclusion should be considered in treatment of descending thoracic aorta emboligenic lesions.
降主动脉腔内移动性血栓在周围栓塞患者中是一种不常见的发现。最佳诊断方法是经食管超声心动图（TEE）。传统上，全身抗凝和选择性手术取栓是标准治疗方法。我们报告一例尽管进行了手术取栓和全身抗凝仍复发移动性血栓的病例。我们在术中同时使用TEE和荧光透视引导，通过腔内支架移植物对降主动脉栓塞性病变进行血管腔内封堵治疗。支架移植物植入9个月后，患者仍无症状。在降主动脉栓塞性病变的治疗中应考虑TEE引导下的血管腔内封堵术。
