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Floating aortic arch thrombus involving the supraaortic trunks: Successful treatment with supra-aortic debranching and antegrade endograft implantation


Rancic, Z; Pfammatter, T; Lachat, M; Frauenfelder, T; Veith, F J; Mayer, D (2009). Floating aortic arch thrombus involving the supraaortic trunks: Successful treatment with supra-aortic debranching and antegrade endograft implantation. Journal of Vascular Surgery, 50(5):1177-1180.

Abstract

A floating thrombus within the aortic arch is a rare condition that is generally detected after cerebral, visceral, or peripheral embolization. Endovascular exclusion of such mobile thrombus has been described but exclusively involved the descending aorta, or debranching of the supra-aortic trunk was done by open surgical bypass procedure. We present a case with a floating thrombus that extended throughout the whole aortic arch and involved all of the supra-aortic trunks. The pathology was treated by debranching the supra-aortic trunks using a new nonsutured Viabahn-based (W. L. Gore & Associates, Flagstaff, Ariz) technique (Viabahn Open Revascularization TEChnique [VORTEC]) for revascularization of the left common carotid artery and performing an antegrade endograft implantation from the ascending aorta, distal to the origin of the feeding graft for debranching, to the descending aorta in one procedure.

A floating thrombus within the aortic arch is a rare condition that is generally detected after cerebral, visceral, or peripheral embolization. Endovascular exclusion of such mobile thrombus has been described but exclusively involved the descending aorta, or debranching of the supra-aortic trunk was done by open surgical bypass procedure. We present a case with a floating thrombus that extended throughout the whole aortic arch and involved all of the supra-aortic trunks. The pathology was treated by debranching the supra-aortic trunks using a new nonsutured Viabahn-based (W. L. Gore & Associates, Flagstaff, Ariz) technique (Viabahn Open Revascularization TEChnique [VORTEC]) for revascularization of the left common carotid artery and performing an antegrade endograft implantation from the ascending aorta, distal to the origin of the feeding graft for debranching, to the descending aorta in one procedure.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:21 July 2009
Deposited On:24 Aug 2009 11:19
Last Modified:05 Apr 2016 13:19
Publisher:Elsevier
ISSN:0741-5214
Publisher DOI:10.1016/j.jvs.2009.05.052
PubMed ID:19628356
Permanent URL: http://doi.org/10.5167/uzh-20299

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