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Floating aortic arch thrombus revealing an occult ascending aortic dissection: a case report
Jose D Bran1, Luis A Vélez1, Juan C Araque1
1Department of Cardiovascular Surgery, Hospital Pablo Tobón Uribe, Medellín, Colombia.
Archivos De Cardiologia De Mexico
|July 16, 2026
Summary
A large floating thrombus in the thoracic aorta caused limb ischemia. Surgical exploration revealed an aortic dissection, highlighting imaging limitations and the value of surgery for high-risk embolization.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Floating thrombus of the thoracic aorta is rare but dangerous, often linked to aortic wall issues.
- Pre-operative imaging may miss underlying causes of aortic thrombi, revealing them during surgery.
Purpose of the Study:
- To report a case of a large floating aortic thrombus causing limb ischemia.
- To emphasize the diagnostic and therapeutic role of surgical exploration in complex aortic thrombus cases.
Main Methods:
- A 49-year-old woman with brachial artery thrombosis underwent computed tomography angiography and echocardiography.
- Urgent surgical intervention included thrombus removal, ascending aortic resection, and Dacron graft reconstruction.
Main Results:
- An 8 cm floating thrombus was found, originating from an ulcerated ascending aortic lesion with contained dissection.
- The patient had an uneventful recovery and was discharged on anticoagulation.
Conclusions:
- Pre-operative imaging can be limited in diagnosing the source of aortic thrombi.
- Surgical exploration is crucial for diagnosis and treatment in high-risk patients with suspected aortic thrombus and embolization.
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