{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T05:10:00Z","timestamp":1779426600197,"version":"3.53.1"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951125109724_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Neonatal aortic thrombosis, though rare, is a critical condition with high morbidity and mortality. Spontaneous thrombosis is uncommon, complicating diagnosis due to its similarity to aortic coarctation. Standard treatments include heparinisation and thrombolysis, but severe cases may require interventional or surgical thrombectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109724_as2\">\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This case series examines interventional therapy in neonates with spontaneous aortic thrombosis, focusing on reduced systolic function or organ failure, and evaluates off-label thrombectomy devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109724_as3\">\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>Three neonates with spontaneous abdominal aortic thrombosis treated at Hannover Medical School between 2017 and 2023 were reviewed. Clinical presentation, diagnostics, treatments, and outcomes were analysed. Treatment involved therapeutic anticoagulation, systemic thrombolysis and interventional thrombectomy using off-label devices. A literature review on interventional thrombectomy in neonates was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109724_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The first neonate, with severe multi-organ failure, died after thrombectomy. The second recovered fully with systemic thrombolysis. The third, critically ill, recovered following successful thrombectomy and thrombolysis. Off-label use of the Amplatzer Vascular Plug II proved more effective than the Amplatzer Piccolo PDA Occluder for managing organised thrombus. A literature review identified seven cases of neonatal aortic thrombectomy using various devices, highlighting interventional thrombectomy as a promising treatment for neonates with cardiac decompensation or imminent organ failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951125109724_as5\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We propose a diagnostic approach for newborns with diminished or absent femoral pulses without structural heart or vascular disease. Interventional thrombectomy is a viable option for neonates with spontaneous aortic thrombosis in life-threatening situations involving decreased systolic function or organ failure. Further studies are needed to evaluate safety and long-term outcomes of catheter-based interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951125109724","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T03:07:11Z","timestamp":1758769631000},"page":"2016-2023","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Tiny clots, big choices: intervening on neonatal aortic thrombosis\u2014a novel framework for clinical decision-making"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9227-7938","authenticated-orcid":false,"given":"Alexandros","family":"Rahn","sequence":"first","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svea","family":"Kleiner","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liudmila","family":"Belevskaia","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3451-0488","authenticated-orcid":false,"given":"Charlotte","family":"Mindermann","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivonne","family":"Wieland","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9510-3154","authenticated-orcid":false,"given":"Nima","family":"Memaran","sequence":"additional","affiliation":[{"name":"Hannover Medical School"},{"name":"Medical University Vienna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris","family":"Franke","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Bohnhorst","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1010-4327","authenticated-orcid":false,"given":"Christoph M.","family":"Happel","sequence":"additional","affiliation":[{"name":"Hannover Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"S1047951125109724_ref31","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.091850"},{"key":"S1047951125109724_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0000000000001134"},{"key":"S1047951125109724_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.76.3.F163"},{"key":"S1047951125109724_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/j.1527-3466.2005.tb00177.x"},{"key":"S1047951125109724_ref15","doi-asserted-by":"publisher","DOI":"10.4103\/apc.APC_26_18"},{"key":"S1047951125109724_ref29","first-page":"408","article-title":"Bivalirudin as an alternative to heparin for anticoagulation in infants and children","volume":"20","author":"Buck","year":"2015","journal-title":"J Pediatr Pharmacol Ther"},{"key":"S1047951125109724_ref17","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951121003267"},{"key":"S1047951125109724_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2011.01.454"},{"key":"S1047951125109724_ref35","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13301"},{"key":"S1047951125109724_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0000000000002455"},{"key":"S1047951125109724_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2022.09.004"},{"key":"S1047951125109724_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951112002077"},{"key":"S1047951125109724_ref24","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2308"},{"key":"S1047951125109724_ref18","unstructured":"18. 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Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re- use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}