COVID-19-Related Spontaneous Aortic Arch Thrombus With Delayed Embolization. Journal Article


Authors: Siddiq, BS; Ward, M; Blecha, M
Article Title: COVID-19-Related Spontaneous Aortic Arch Thrombus With Delayed Embolization.
Abstract: Presentation of a 62-year-old man with baseline chronic obstructive pulmonary disease admitted to the hospital with dyspnea and newly diagnosed COVID-19 infection. CT scan of the chest was obtained to rule out pulmonary embolism. This revealed a mural thrombus of the inner curvature of the aortic arch with a floating component. Therapeutic full dose anticoagulation was initiated in combination with close clinical observation and treatment for modest hypoxia. He did well for 1 month and then returned with ischemic rest pain of the right foot. Angiography revealed thrombosis of all 3 tibial arteries in the right leg. Percutaneous mechanical thrombectomy with tissue plasminogen activator injection and angioplasty was performed with success in 1 tibial artery to achieve in line flow to the foot. After continued anticoagulation, the remainder of the tibial arteries autolysed and the aortic thrombus was noted to be resolved 4 months later. A brief pathophysiology discussion is included.
Journal Title: The American Surgeon
ISSN: 1555-9823; 0003-1348
Publisher: Unknown  
Date Published: 2021
LUC Authors
  1. Matthew Blecha
    22 Blecha