Non-diseased aortic mural thrombus presenting with acute limb ischaemia

Area of Science:

• Cardiovascular Medicine
• Vascular Surgery
• Diagnostic Imaging

Background:

• Thoracic aortic mural thrombus (AMT) is uncommon, particularly in non-atherosclerotic and non-aneurysmal aortas.
• Acute limb ischemia is a rare presentation for AMT in a healthy aorta.
• Underlying hypercoagulable disorders are often associated with aortic thrombus formation.

Observation:

• A patient presented with acute limb ischemia secondary to a thoracic aortic mural thrombus.
• The aorta was assessed as non-atherosclerotic and non-aneurysmal.
• No underlying hypercoagulable disorder was identified in the patient.

Findings:

• The thoracic aortic mural thrombus was successfully managed with anticoagulation therapy.
• Follow-up CT scans at 5 months showed complete resolution of the thrombus.
• This case demonstrates the efficacy of medical management for AMT in a non-diseased aorta.

Implications:

• Successful anticoagulation offers a less invasive treatment option for selected cases of thoracic aortic mural thrombus.
• This case contributes to the limited literature on managing AMT in the absence of aortic disease or hypercoagulability.
• Further research into the etiology and optimal management strategies for non-atherosclerotic AMT is warranted.