Effect of Anticoagulation Therapy in Management of Isolated Non-Occlusive Thrombosis of Non-Aneurysmal Aorta

Document Type : Original Article

Authors

1 Department of Vascular Surgery, Faculty of Medicine, Ain Shams University, Egypt

2 Vascular Surgery Unit, Faculty of Medicine, Helwan University, Egypt

Abstract

Nowadays, there are no established consensus or guidelines for aortic thrombus management.
Aim of work: to assess the effect of anticoagulation therapy in managing this thrombus as a non-invasive modality.
Methods: It is a prospective cohort study of isolated non-aneurysmal aortic non-occlusive thrombus and were treated conservatively by Therapeutic dose of anticoagulation. All patients were assessed initially, by clinical examination and CT angiography of whole aorta. Follow up plan was focusing on clinical evidence of distal arterial embolization and recurrent aortic thrombus by CT angiography of whole aorta.
Results: During the study period, only 10 cases were presented by aortic non-occlusive thrombosis without aneurysm. Four patients were asymptomatic while 6 cases were presented with lower limb acute ischemia. All patients received Therapeutic dose of Low Molecular Weight Heparin (Till complete resolution of aortic thrombus, which were achieved in 7 cases after 1 month of treatment and in the remaining 3 cases after 3 months of treatment, confirmed during CT angiography follow up after that patients resumed treatment using Apixaban 5mg twice daily with No distal embolization detected clinically in peripheral circulation. All cases completed the study period without recurrent aortic thrombus formation.
Conclusion: Aortic non-occlusive thrombus without aneurysm is a dangerous source of systemic embolization.
Offering Anticoagulation therapy as an effective and non-invasive approach, it has high success rate with no reported complications, in contrast to other invasive modalities. We call for randomized multicentric studies due to scanty reported cases.

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