Thoracic Endovascular Aortic Repair in a Patient with Mobile
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Abstract
A 58-year-old female presented with acute arterial insufficiency to her left leg. Following cardiovascular evaluation using multimodality imaging, it was discovered that she had mobile thoracic thrombi overlying a normal descending thoracic aorta which had also caused a splenic infarction. This patient was treated with unfractionated heparin for three days and underwent subsequent thoracic endovascular aortic repair (TEVAR) uneventfully with no subsequent complications at one-year followup. This case highlights the diagnostic and therapeutic challenges in treating patients with this uncommon challenging clinical scenario.

Case Scenario
A 58-year-old female presented with symptoms and signs compatible with an acutely threatened left leg. Her history revealed that she had no preexisting significant cardiovascular symptoms of note and she had no risk factors for atherosclerosis. There was no family history to suggest any hereditary thrombotic disorders.

A computed tomography angiogram (CTA) was performed which confirmed abrupt cutoff of the left mid- to distal tibial artery in the left leg, as well as a recanalized splenic infarction. In addition, as part of her workup before referral, a CTA of the thoracic aorta was performed which revealed a linear filling defect measuring 8?cm which was interpreted as an aortic dissection with an intimal flap....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3971888/
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