An aortic thrombosis is a medical emergency. It happens when a blood clot forms in the aorta, the main artery leading away from the heart. It’s a very rare condition but can quickly lead to life threatening complications.

An aortic thrombosis (also known as a plural thrombosis) is when a blood clot blocks the main artery (aorta) that carries blood away from your heart. It’s a rare condition that can be potentially life threatening if it blocks blood flow to your organs or extremities.

An aortic thrombosis is a medical emergency that requires prompt medical attention to avoid life threatening complications. Because of its rarity, the best way to treat aortic thromboses is still controversial. Typically, doctors either surgically remove the blood clot or administer medications to break it up.

Read on to learn more about an aortic thrombosis, including the causes, symptoms, and treatment options.

A group of risk factors known as Virchow triad, named after Dr. Rudolf Virchow, are associated with an increased risk of developing an aortic thrombosis and thromboses in other blood vessels. This triad is made up of:

  • blood vessel wall injury, from catheterization and other causes
  • hypercoagulability of blood, meaning blood is too thick and sticks together too easily
  • changes in blood flow caused by activities, such as extended periods of immobility

Many cases of aortic thromboses are linked to heart catheters. A heart catheter is often used to help diagnose or treat heart conditions. It’s a hollow tube that’s inserted into an artery or vein in your groin, neck, or arm and then guided through your blood vessels until it reaches your heart.

When a catheter is guided to the heart, it can cause the wall of the aorta to become inflamed. This, in turn, can increase the risk of a blood clot developing in the aorta.

The sudden inflammation of blood vessels can also potentially put you at risk of developing an aortic thrombosis. This can be caused by:

Aortic thromboses that develop with an unclear origin, also called spontaneous aortic thromboses, are extremely rare.

Aortic thrombosis and COVID-19

An aortic thrombosis has been reported as a rare complication of COVID-19.

In a 2020 case series, researchers reported four cases of people who developed an aortic thrombosis who were admitted to the hospital with respiratory symptoms and who received a confirmed COVID-19 diagnosis. One of the four people passed away in the hospital.

It’s thought that COVID-19 might predispose people to an aortic thrombosis in multiple ways, including:

  • increased inflammation
  • immobilization (extended bed rest)
  • narrowing of blood vessels
  • blood hypercoagulability

Aortic thrombosis associated with chemotherapy or estrogen therapy

The risk of developing thrombosis is thought to be elevated in people with cancer or who are receiving chemotherapy or estrogen therapy.

In an older case series, researchers reported on four patients who developed an aortic thrombosis while on a course of cisplatin-based chemotherapy.

An aortic thrombosis can be mistaken for a stroke or other neurological conditions. The signs and symptoms can range from mild to fatal and may include:

Doctors primarily diagnose an aortic thrombosis with imaging. The most frequently used imaging technique is a Doppler ultrasound which uses high frequency sound waves to measure blood flow through the blood vessels. The procedure is painless.

Other techniques that may be used to help diagnose an aortic thrombosis include:

An aortic thrombosis is usually treated with medications to break up the blood clot or surgery. However, there’s little consensus in the medical community on how to best treat them. The best treatment option may depend on where the blood clot develops and how large it is.

In a 2022 review of studies, researchers found that 50% of people with aortic thromboses in the aorta were treated with medications. Additionally, 34% were managed with minimally invasive endovascular procedures and 16% were managed with traditional surgery.

Medications alone may successfully dissolve the blood clot. These include:

In some instances, a blood clot may be surgically removed. This is most likely if:

  • the blood clot has a mass greater than 1 centimeter across
  • you have a history of blood clots
  • the clot develops in certain parts of the aorta
  • it’s not possible to distinguish the blood clot from a mass on imaging tests

An aortic thrombosis can be mild or cause severe and possibly life threatening complications.

Due to the rarity of this condition, limited information is available on the survival rates for people who develop aortic thromboses. However, it’s believed that they’re fatal in up to 75% of cases.

If a thrombosis blocks blood flow through the aorta, it can restrict or prevent blood from flowing to any organ system. If treatment isn’t initiated quickly, it can lead to sudden and severe complications that include:

In the 2020 case series of four people with COVID-19 and aortic thrombosis:

  • two people developed a stroke
  • one person developed a pulmonary embolism
  • two people developed acute limb ischemia, which is a loss of blood flow to a limb
  • one person developed acute mesenteric ischemia, which is a loss of blood flow to the intestines
  • one person developed deep vein thrombosis

An aortic thrombosis is when a blood clot blocks or restricts blood flow in the aorta, the main artery that carries blood away from your heart to the rest of your body. It’s a very rare condition, but can quickly lead to life threatening complications.

Researchers are still investigating the best way to treat aortic thromboses. Doctors usually either remove the blood clot surgically or administer medications to break up the clot.