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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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PERIPHERAL ARTERIES  HANDLING OF AORTIC AND PERIPHERAL ARTERIAL PATHOLOGIES


The Journal of Cardiovascular Surgery 2017 April;58(2):313-20

DOI: 10.23736/S0021-9509.16.09798-6

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of acute aortic thrombosis

Mark KASCHWICH , Christian A. BEHRENDT, Nikolaos TSILIMPARIS, Tilo KÖLBEL, Sabine H. WIPPER, Eike S. DEBUS

Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center, University Hospital Eppendorf, Hamburg, Germany


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Acute aortic thrombosis (AAT) is a rare life threatening event that leads to a sudden occlusion of the aorta. The mortality and morbidity of AAT is still high despite modern surgical techniques. Usually it is the result of a large saddle embolus to the aortic bifurcation, in situ thrombosis of an atherosclerotic aorta or acute occlusion of an abdominal aortic aneurysm. Clinical symptoms depend on the level of the aortic occlusion and can be mistaken for a stroke or similar neurological disease. The combination of age and advanced cardiac disease seems to be significant risks factors for AAT. In patients who have no cardiac or vascular disease this catastrophic event is very rare and is mostly due to hypercoagulable disorders. Revascularization of the ischemic organ/limb as soon as possible is the major aim in the therapy of AAT to avoid further ischemic damage. Surgical reperfusion is the first line approach. If the accepting clinic has no facilities for an immediate surgical intervention it is of primary importance that these patients should be referred to an appropriate center for further management. Paradox seems the fact that most of the patients die as a consequence of reperfusion injury/postperfusion syndrome that occurs after revascularization of acute ischemic limbs.


KEY WORDS: Thrombosis - Vascular diseases - Reperfusion injury

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Publication History

Issue published online: February 27, 2017
Article first published online: December 22, 2016

Per citare questo articolo

Kaschwich M, Behrendt CA, Tsilimparis N, Kölbel T, Wipper SH, Debus ED. Management of acute aortic thrombosis. J Cardiovasc Surg 2017;58:313-20. DOI: 10.23736/S0021-9509.16.09798-6

Corresponding author e-mail

m.kaschwich@uke.de