J Cardiovasc Ultrasound.  2009 Dec;17(4):148-150. 10.4250/jcu.2009.17.4.148.

A Case of Huge Thrombus in the Aortic Arch with Cerebrovascular Embolization

• Song IW
• Hong GR
• Cho JH
• Jung SY
• Son CW
• Lee SH
• Kim YJ
• Shin DG
• Park JS
• Shim BS

• KMID: 1473720
• DOI: http://doi.org/10.4250/jcu.2009.17.4.148

Abstract

Pedunculated thrombus in the aortic arch that is associated with cerebral infarction is very rare requires prompt diagnosis and treatment to prevent occurrence of another devastating complication. Transesophageal echocardiography is useful for detecting source of embolism including aortic thrombi. The treatment options of aortic thrombi involves anticoagulation, thrombolysis, thromboaspiration, and thrombectomy. Here we report a case of huge thrombus in the aortic arch, resulting in acute multifocal cerebellar embolic infarct in patient without any risk factors for vascular thrombosis. Thrombi in the aortic arch were diagnosed by transesophageal echocardiography and treated with anticoagulants successfully.

Keyword

Aortic thrombus; Echocardiography

MeSH Terms

Anticoagulants
Aorta, Thoracic
Cerebral Infarction
Echocardiography
Echocardiography, Transesophageal
Embolism
Humans
Risk Factors
Thrombectomy
Thrombosis
Anticoagulants

Figure

• 

  Fig. 1 Brain magnetic resonance imaging, acute infarct on right posterior internal communicating artery territory and multifocal cerebellum (arrow).

• 

  Fig. 2 Transesophageal echocardiogram demonstrates a large mobile protruding mass (arrow) in the aortic arch in transverse (A) and longitudinal (B) views.

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  Fig. 3 Multi-detector computed tomography scan demonstrate the mass in the aortic arch (arrow).

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  Fig. 4 Follow-up transesophageal echocardiogram shows small remnant thrombus in the base of atheromatous plaque (arrow)(B) compare with before anticoagulation therapy (arrow)(A).

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