Successful Endovascular Treatment for Aortic Thrombosis Due to Primary Antiphospholipid Syndrome: A Case Report and Literature Review.
Yoshito KadoyaKan ZenYohei OdaSatoaki MatobaPublished in: Vascular and endovascular surgery (2018)
A 60-year-old man with a history of Raynaud's phenomenon presented with bilateral intermittent claudication and an ulcer on his right toe. The ankle-brachial index of the right and left legs was 0.77 and 0.75, respectively. Laboratory data showed prolongation of the activated partial thromboplastin time and a positive result on the lupus anticoagulant test. Computed tomography angiography revealed isolated infrarenal aortic stenosis with irregular surface and noncalcified plaques. Intravascular ultrasonography examination demonstrated a noncalcified, irregular, and mobile plaque, suggestive of abdominal aortic thrombosis. In addition to anticoagulant and dual antiplatelet therapy, endovascular treatment was performed. A total of three 40-mm-long balloon-expandable stents were successfully implanted on a 15-mm balloon. The final angiography showed good results except for minimal plaque shifting in the terminal aorta. Three months later, the ulcer resolved and a final diagnosis of primary antiphospholipid syndrome (APS) was made. Clinicians should recognize that APS can affect the abdominal aorta, leading to aortic thrombosis. Endovascular treatment may be the one good treatment option for this rare condition.
Keyphrases
- endovascular treatment
- aortic valve
- aortic stenosis
- antiplatelet therapy
- transcatheter aortic valve replacement
- aortic valve replacement
- transcatheter aortic valve implantation
- pulmonary embolism
- abdominal aortic
- pulmonary artery
- coronary artery
- acute coronary syndrome
- left ventricular
- percutaneous coronary intervention
- atrial fibrillation
- coronary artery disease
- venous thromboembolism
- magnetic resonance imaging
- systemic lupus erythematosus
- optical coherence tomography
- aortic dissection
- computed tomography
- palliative care
- ejection fraction
- high intensity
- peripheral artery disease
- machine learning
- pulmonary arterial hypertension
- case report
- electronic health record
- replacement therapy
- contrast enhanced
- magnetic resonance
- disease activity
- image quality
- combination therapy
- artificial intelligence