Aortic Thrombosis in a Patient With Malignant Disease: A Literature Review and Case Presentation

Vasc Endovascular Surg. 2019 Feb;53(2):139-144. doi: 10.1177/1538574418813623. Epub 2018 Nov 22.

Abstract

Introduction:: Aortic mural thrombosis associated with a malignant disease is rare, and whether anticoagulation therapy or surgical treatment is the more definitive primary treatment remains uncertain. This study aims to determine the best treatment strategy for aortic thrombosis in a patient with a malignant disease.

Methods:: We reviewed medical literature using the PubMed database and present a case of aortic thrombosis due to a hypercoagulable state related to sigmoid colon adenocarcinoma.

Results:: Of the 18 patients from 14 articles included in this study, 13 received simple anticoagulation as a primary treatment (anticoagulation group), while 5 underwent surgical treatment (surgical treatment group). Recurrence or exacerbation of embolism was found in 2 (15.4%) of the 13 patients and in 1 (20.0%) of the 5 patients ( P = 1.0). Major complications were observed in 1 (7.7%) of the patients in the anticoagulation group and in 1 (20.0%) of the 5 patients in the surgical treatment group ( P = .49). No significant differences between the groups were found.

Conclusions:: A simple anticoagulation therapy may be as effective as surgical treatment in patients with aortic thrombosis associated with malignancy.

Keywords: aorta; hypercoagulable state; neoplasms; thrombosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / complications*
  • Adenocarcinoma / diagnosis
  • Anticoagulants / administration & dosage
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / drug therapy
  • Aortic Diseases / etiology*
  • Aortography / methods
  • Computed Tomography Angiography
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Heparin / administration & dosage
  • Humans
  • Middle Aged
  • Sigmoid Neoplasms / blood
  • Sigmoid Neoplasms / complications*
  • Sigmoid Neoplasms / diagnosis
  • Thrombosis / diagnostic imaging
  • Thrombosis / drug therapy
  • Thrombosis / etiology*
  • Treatment Outcome

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Heparin