Resolution of an aortic thrombus under anticoagulant therapy

In a 50-year-old woman, admitted because of a renal infarction, a 10-cm long floating, highly mobile thrombus with a diameter of 15-20 mm in the descending aorta was detected by transoesophageal echocardiography and magnetic resonance imaging. She was a poor surgical candidate due to obstructive lung disease and obesity. Under intravenous heparinization with prothrombin time test values between 80 and 100 s, followed by oral anticoagulation with international normalized ratio values between 3.0 and 4.0, the thrombus resolved after 10 weeks and no recurrence occurred over the next 30 months.