2Samir Abou Zied

1Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 2Faculty of Medicine, Cairo University, Cairo, Egypt

Background:

Floating aortic thrombus is infrequent diagnosis in our daily work, with no standard guidelines of treatment. we present a complicated case of floating aortic thrombus highlighting the management strategy and outcomes.

Material(s) and Method(s):

58 years male patient referred to our institute with acute mesenteric vascular occlusion,with septic shock , daignosed as SMA thrombus ,under went exploration  for SMA thrombectomy and assessment of intestinal viabilty.workup showed that he had 2 big floating aortic thrombus in the descending thoractic aorta thant managed by endovascular covered stent after failure of anticoagulation

Result(s):

Patient underwent successful SMA thrombectomy with regain of blood supply to the intestine with no need for intestinal  resection , and improvement of general condition, therapeutic anticoagulation failed to stabilize the aortic thrombus as he got second attack of peripheral embolization to the left lower limb.. successful exclusion of the floating aortic thrombus by covered stent graft and femoral embolectomy with good short and mid term results.

Conclusion(s):

Floating aortic thrombus is serious condition that need individualization of management according to the presentation..

Endovascular treatment is good option for cases showed recurrent embolization despite of therapeutic anticoagulation.