Right atrial thrombus treated with catheter directed thrombolysis

Abstract

Objective: Presented is a single-case of a novel technique of catheter-directed thrombolysis via an existing implanted venous-access port for treatment of a right atrial thrombus. Case presentation: A 51-year-old woman with metastatic colon cancer, being treated with chemotherapy via a MediPort was found to have a large right atrial thrombus (2.8 × 4.7 × 2.3 cm) adjacent to the MediPort tip on follow-up chest CT. The patient received three months of anticoagulation without improvement. Due to the location of the thrombus, the patient was treated with continuous infusion of tissue plasminogen activator through the MediPort at a rate of 1 mg/hr for 24 h. Results: Transthoracic echocardiogram at 24 h demonstrated no visible thrombus. 1 month follow up TTE revealed resolution of RA thrombus. Conclusion: A catheter-directed thrombolysis is the effective approach to treat a catheter induced thrombus, while lowering the systemic risk of thrombolytic therapy.

Keywords

• Atrial thrombus
• thrombolysis
• catheter-associated thrombus