Neonatal Aortic Thrombosis: A Comprehensive Review

BACKGROUND: Neonatal aortic thrombosis is a rare occurrence, but can be fatal. Treatment of this condition is hampered by the lack of large studies involving this pediatric population. Reporting of this condition is also not standardized. METHODS: The purpose of this review is to collate available literature on the incidence, risk factors, presentation, treatment and outcome of neonatal aortic thrombosis as well as suggest a treatment model. RESULTS: A Medline search of PubMed, OVID and Cochrane databases was undertaken using the key words "neonatal", "infant", "aorta", "aortic", "thrombosis", "thrombus" and "clot". Limits were set for articles that were English language only and published between 1980 and September 2009. Following review of all articles using predetermined search words and criteria, 38 were found with sufficient data for our purpose. The reported total number of neonatal patients with aortic thrombosis was 148 and 78% of the aortic thromboses in this review were related to arterial umbilical catheterization. CONCLUSIONS: We have suggested a classification system to standardize reporting of neonatal aortic thrombosis, as well as a treatment decision tree, and a clinical guide for the treatment of thrombosis in children. As always, clinicians should balance the risks and benefits of their decision to treat with the level of local expertise. This guide may specifically serve the neonatal population with line-related aortic thrombosis.