Recurrent embolism caused by floating thrombus in the thoracic aorta.
A case of embolic recurrent episodes resulting in acute lower-limb ischemia from an unusual source is reported. This occurred in a patient on steroids for rheumatoid arthritis. Femoropopliteal thromboembolectomy successfully restored arterial flow. Diagnostic evaluation for identifying the source of embolism revealed a large, pedunculated and mobile thrombus arising from a nonaneurysmatic and nonatherosclerotic descending thoracic aorta. The thrombus was identified by transesophageal echocardiography and was successfully removed by aortic thromboendarterectomy. We emphasize the importance of transesophageal echocardiography as a reliable method for the diagnosis of thoracic aorta diseases and for identification of aortic thrombi. An aggressive surgical approach is recommended in the low-risk patient to prevent further embolic episodes.
Lozano
P
P
Department of Angiology and Vascular Surgery, Hospital Son Dureta, Mallorca, Spain.
Gomez
F T
FT
Julia
J
J
M-Rimbau
E
E
Garcia
F
F
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001013:Aorta, Thoracic; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D017548:Echocardiography, Transesophageal; D004617:Embolism / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery
D000893:Anti-Inflammatory Agents; D011241:Prednisone