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Anticoagulant therapy and TEVAR in a patient with antiphospholipid syndrome presenting with pulmonary embolisms and multiple arterial embolisms due to thoracic aortic mural thrombosis
- Source :
- Journal of Cardiology Cases
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
Abstract
- We often observe patients with antiphospholipid syndrome (APS) presenting with both venous and arterial thrombi. Anticoagulant therapy is effective for venous and peripheral arterial embolisms in these patients; however, it has opposite effects when applied for thoracic aortic mural thrombosis because of the risk of new arterial embolisms. Recently, thoracic endovascular aortic repair (TEVAR) has been used to prevent arterial embolisms due to aortic thrombosis. However, we generally hesitate to implant artificial materials in patients in a hypercoagulable state because this can cause new thrombi to develop. Here, we present a case of successful treatment by anticoagulant therapy and TEVAR in an APS patient presenting with pulmonary embolisms (PEs) and multiple arterial embolisms due to thoracic aortic mural thrombosis. A 46-year-old man was referred to our hospital due to dyspnea and leg pain. Since contrast-enhanced computed tomography revealed PEs, thoracic aortic mural thrombosis, and lower limb arterial embolisms, we administered anticoagulation therapy. Three days later, contrast-enhanced computed tomography revealed new arterial embolisms in the right kidney. To prevent further arterial embolisms due to thoracic aortic mural thrombosis, we performed emergent TEVAR in addition to anticoagulant therapy. Thereafter, no venous or arterial embolisms recurred during the 13-month follow-up period.
- Subjects :
- medicine.medical_specialty
Thoracic endovascular aortic repair
Computed tomography
030204 cardiovascular system & hematology
Thoracic aortic mural thrombus
Article
03 medical and health sciences
0302 clinical medicine
Antiphospholipid syndrome
Internal medicine
medicine
In patient
cardiovascular diseases
030212 general & internal medicine
Artificial materials
medicine.diagnostic_test
business.industry
Leg pain
medicine.disease
Anticoagulant therapy
Mural thrombosis
cardiovascular system
Cardiology
Cardiology and Cardiovascular Medicine
business
Aortic thrombosis
Subjects
Details
- ISSN :
- 18785409
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiology Cases
- Accession number :
- edsair.doi.dedup.....16eb96851dc329eb16ee08616af63518