Management Strategies for Descending Thoracic Aortic Thrombus: A Review of the Literature

Descending thoracic aortic thrombus (DTAT) is an under-recognized source of systemic emboli with potential catastrophic consequences. Imaging modalities such as echocardiography, computed tomography, magnetic resonance imaging, and angiography can help identify and characterize the extent of embolic events. Established guidelines regarding the management of DTAT are currently lacking. Multiple treatment modalities are available; however, the effectiveness of each approach remains to be determined. In this study, we performed a review to examine the clinical presentation, diagnostic methods and findings, and outcomes of various treatment options for patients with DTAT. Medical management is the least invasive and most frequently chosen initial approach, offering a high reported success rate, whereas endovascular therapy can have a role in thrombus exclusion should conservative management fail.