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Bilateral intermittent claudication and the aorta

Johann Auer1, Robert Berent, Thomas Weber

  • 1Departments of Cardiology and Intensive Care, General Hospital Wels, Grieskirchnerstrasse 42, A-4600, Wels, Austria. johann.auer@khwels.at

Heart and Vessels
|March 26, 2004
PubMed

Insights

Giant aortic thrombus caused peripheral emboli in a 70-year-old man presenting with intermittent claudication. Long-term anticoagulation successfully treated the systemic thromboembolism, highlighting this rare cause of limb ischemia.

Area of Science:

  • Vascular Surgery
  • Cardiology
  • Radiology

Background:

  • Peripheral emboli are increasingly recognized as originating from aortic thrombi, often detected via advanced imaging like transesophageal echocardiography and MRI.
  • Aortic thrombi can lead to systemic thromboembolism, causing diverse clinical presentations.

Observation:

  • A 70-year-old male presented with bilateral intermittent claudication.
  • Arteriography showed distal tibial artery occlusions without evidence of atherosclerotic disease in major limb arteries or vascular calcification.
  • A large thrombus in the descending aorta was identified as the source of emboli.

Findings:

  • The patient's symptoms of intermittent claudication were attributed to a giant descending aortic thrombus.
  • Systemic thromboembolism originated from the aortic thrombus, not from localized atherosclerotic disease.

Implications:

  • This case underscores the importance of considering aortic thrombus as a source of peripheral arterial occlusion, even in the absence of typical atherosclerosis.
  • Effective management of aortic thrombus involves anticoagulation to prevent further embolic events.
  • Advanced imaging plays a crucial role in diagnosing rare causes of limb ischemia.

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