CTICasesImpella-Induced Aortic Thrombus
Imaging findings
CT angiography shows a large, mobile thrombus along the wall of the descending thoracic aorta, tracking down to the iliac/femoral arteries, in a patient who recently had an Impella ventricular assist device placed, presenting with acute limb ischemia and stroke.
Key takeaways
Mechanical circulatory support devices like the Impella can cause mechanical trauma to the aortic intima during insertion, positioning, or removal. This intimal injury can lead to large, mobile thrombus formation on the aortic wall, posing a high risk of systemic embolization (causing stroke or acute limb ischemia).
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