Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0044-1787790
Floating Thrombus in the Aortic Arch: Rare Images
Abstract
Aortic floating thrombus is a rare, life-threatening disease. Most cases of aortic thrombus are diagnosed after embolic events; however, on rare occasion we may diagnose this condition incidentally during routine examinations as in our case.
#
A 76 year-old patient, with a history of ischemic cardiomyopathy and chronic smoking, presented with bilateral lower limb white edema (typical of heart failure) with New York Heart Association stage II dyspnea evolving over a period of 3 days, all in a context of apyrexia and conservation of general condition.
On examination, we found a conscious patient with bilateral sibilant rales.
The laboratory results showed high levels of plasma D-Dimer at 418 ng/mL (normal range < 250 ng/mL).
Computed tomography angiography (CTA) demonstrated a filling defect suggestive of a thrombus in an otherwise healthy appearing aortic arch ([Fig. 1]).
![](https://www.thieme-connect.de/media/10.1055-s-00039245/EFirst/thumbnails/10-1055-s-0044-1787790-i230004-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)
After careful consideration, conservative treatment using oral anticoagulation (low-molecular-weight heparin) was preferred as the first choice since the patient was considered unfit for open aortic arch surgery given his advanced age, unfortunately the patient died a day after initiation of anticoagulation.
Aortic floating thrombus is a rare, life-threatening disease.[1] Most cases of aortic thrombus are diagnosed after embolic events; however, occasionally we may diagnose this condition incidentally during routine examinations as in our case.[2] CTA identifies and localizes aortic thrombi and may disclose asymptomatic peripheral or visceral embolism.[3]
#
Conflict of Interest
None declared.
-
References
- 1 Yang S, Yu J, Zeng W. et al. Aortic floating thrombus detected by computed tomography angiography incidentally: five cases and a literature review. J Thorac Cardiovasc Surg 2017; 153 (04) 791-803
- 2 Konstantinos T, Dimitrios K, Marianthi T, Nikolaos S, Ioannis L. Aortic arch floating thrombus complicated by distal embolization in a patient with malignancy. Case Rep Vasc Med 2018; 2018: 2040925
- 3 Wang B, Ma D, Cao D, Man X. Huge thrombus in the ascending aorta: a case report and literature review. J Cardiothorac Surg 2019; 14 (01) 157
Address for correspondence
Publication History
Received: 20 January 2023
Accepted: 07 February 2024
Article published online:
25 June 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Yang S, Yu J, Zeng W. et al. Aortic floating thrombus detected by computed tomography angiography incidentally: five cases and a literature review. J Thorac Cardiovasc Surg 2017; 153 (04) 791-803
- 2 Konstantinos T, Dimitrios K, Marianthi T, Nikolaos S, Ioannis L. Aortic arch floating thrombus complicated by distal embolization in a patient with malignancy. Case Rep Vasc Med 2018; 2018: 2040925
- 3 Wang B, Ma D, Cao D, Man X. Huge thrombus in the ascending aorta: a case report and literature review. J Cardiothorac Surg 2019; 14 (01) 157
![](https://www.thieme-connect.de/media/10.1055-s-00039245/EFirst/thumbnails/10-1055-s-0044-1787790-i230004-1.jpg)
![Zoom Image](/products/assets/desktop/css/img/icon-figure-zoom.png)