{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:15:17Z","timestamp":1787004917170,"version":"build-2736575974"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Angiol"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background:\u2003Embolization to multiple arterial beds associated with primary aortic mural thrombus (PAMT) could result in high morbidity and mortality. There are no recommendations to dictate the best management. This study aims to describe our experience in managing this rare disease.<\/jats:p>\n                  <jats:p>Methods:\u2003A retrospective review of all patients affected by PAMT treated at our institution between January 2015 and December 2021 was performed. Recorded data included demographics, prothrombotic risk factors, imaging findings, clinical presentation, and treatment. Primary outcomes comprised thrombus recurrence, major amputation, and death.<\/jats:p>\n                  <jats:p>Results:\u2003Thirteen patients with PAMT have been included. The median age was 52 years (36\u201368 years), and the male\/female ratio was 1:1.6. The diagnosis of PAMT was made by computed tomography angiography (CTA) in all cases. Prothrombotic conditions were identified in 92% of cases, and most patients (92%) had thoracic PAMT. The most common presentation was acute limb ischemia after thrombus embolization (85%), requiring surgical revascularization. Anticoagulation was promptly started in all patients. Two patients developed heparin-induced thrombocytopenia. Recurrence of embolization\/thrombosis was observed in 54% of patients; two underwent endovascular thrombus exclusion with a stent graft. We identified one PAMT-related death and one major amputation with a median follow-up time of 39 months (12\u201364 months).<\/jats:p>\n                  <jats:p>Conclusion:\u2003Anticoagulation alone as initial therapy could completely resolve PAMT but is associated with high embolization recurrence. Thoracic endovascular aortic repair is feasible and could prevent additional embolization. However, the criteria for its use as a first-line therapy still need to be defined. Our study highlights the importance of closely monitoring these patients.<\/jats:p>","DOI":"10.1055\/s-0044-1779489","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T18:57:35Z","timestamp":1707245855000},"page":"156-164","source":"Crossref","is-referenced-by-count":5,"title":["The Challenge of Managing a Primary Aortic Mural Thrombus: Outcomes and Technical Considerations"],"prefix":"10.1055","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-012X","authenticated-orcid":false,"given":"Daniel","family":"Mendes","sequence":"additional","affiliation":[{"name":"Department of Angiology and Vascular Surgery, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Veiga","sequence":"additional","affiliation":[{"name":"Department of Angiology and Vascular Surgery, Hospital de Braga, Braga, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Angiology and Vascular Surgery, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"S\u00e1-Pinto","sequence":"additional","affiliation":[{"name":"Department of Angiology and Vascular Surgery, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, Porto, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Almeida","sequence":"additional","affiliation":[{"name":"Department of Angiology and Vascular Surgery, Centro Hospitalar Universit\u00e1rio de Santo Ant\u00f3nio, Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences, University of 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