Medical management of a large aortic thrombus in a young woman with essential thrombocythemia.

Abstract:

:Aortic thrombus formation is rare in the patients with essential thrombocytosis (ET); therefore, no guidelines for its management have been established. Embolism from ET-associated large vessel thrombi is potentially lethal and has been managed surgically in a few reported cases. We describe herein a 45-year-old black woman with ET found to have a 3.5-cm, pedunculated intra-aortic thrombus at the thoracoabdominal junction. How to treat this potentially devastating aortic thrombus was a management dilemma. We believed, based on the patient's diagnosis of ET and the histology of similar thrombi in 1 reported series, that the aortic thrombus was a "white thrombus" consisting primarily of aggregated platelets with a minimal fibrin network and almost no entrapped erythrocytes. The patient was treated with aspirin, 325 mg daily, as a platelet antiaggregating agent and hydroxyurea, 1,500 mg daily, to reduce the platelet count to less than 450 x 10(9)/L. The thrombus resolved without severe thromboembolic events. To our knowledge, this is the first reported case of a large intra-aortic thrombosis associated with ET that has been successfully managed with medical therapy alone.

journal_name

Mayo Clin Proc

journal_title

Mayo Clinic proceedings

authors

Fang M,Agha S,Lockridge L,Lee R,Cleary JP,Mazur EM

doi

10.4065/76.4.427

keywords:

subject

Has Abstract

pub_date

2001-04-01 00:00:00

pages

427-31

issue

4

eissn

0025-6196

issn

1942-5546

pii

S0025-6196(11)62392-6

journal_volume

76

pub_type

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