thrombosis of the aorta

Introduction

acute occlusion of the aorta by thrombosis is a rare life threatening event causing severe distal ischaemia (eg. acute limb ischaemia and renal infarct / infarction) and high risk of distal emboli
chronic complete occlusions of a AAA are rare but may be asymptomatic ¹⁾
the high blood flow rates generally mean that complete thrombosis of the aorta is much less likely than in smaller arteries
a mural aortic thrombus may form with aortic dissection, aortic aneurysm, malignancy, and blood disorders and is rarely seen in a healthy subject
- most occur in the distal aortic arch or in the region of the aortic isthmus but can occur in the abdominal aorta

aortic dissection
abdominal aortic aneurysm (AAA)
- although mural thrombus in an abdominal aortic aneurysm is common, complete thrombosis of an abdominal aneurysm is extremely rare
neoplasia / cancer / tumours
thrombophilia
- COVID-19 coronavirus (2019-nCoV / SARS-CoV-2) ²⁾
- thrombocytosis
intra-aortic catheters
- ECMO
- umbilical artery catheters (UACs) are the most common cause in neonates
  - some degree of aortic thrombosis accompanies 20% to 30% of UACs
  - 89% of neonates experiencing aortic thrombosis had indwelling arterial catheters
idiopathic thrombosis of the aorta may occur in neonates
other risk factors include:
- chemotherapy
- smoking
- atherosclerosis and primary prevention
- iron deficiency
- recent abdominal surgery
- cessation of anticoagulation for thrombophilia

CT chest/abdomen main demonstrate it even without contrast, but may need CT aortogram

immediate referral to vascular surgery (+/- interventional radiology)
- surgical thrombectomy may cause massive thrombus shedding, and mesenteric artery or iliac femoral artery embolism
- a temporary retrievable stent filter (RSF) may be an option ³⁾

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