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Recurrent embolism caused by floating thrombus in the thoracic aorta
1Department of Angiology and Vascular Surgery, Hospital Son Dureta, Mallorca, Spain.
Annals of Vascular Surgery
|December 5, 1998
Summary
Recurrent leg ischemia was caused by a mobile aortic thrombus, a rare condition. Surgical removal of the thrombus prevented further embolic events, highlighting the importance of advanced imaging.
Area of Science:
- Vascular Surgery
- Cardiology
- Rheumatology
Background:
- Rheumatoid arthritis (RA) patients on corticosteroids have an increased risk of thromboembolic events.
- Lower-limb ischemia can result from arterial embolism, necessitating prompt diagnosis and treatment.
Observation:
- A patient with rheumatoid arthritis experienced recurrent acute lower-limb ischemia due to arterial embolism.
- Transesophageal echocardiography identified a large, mobile thrombus originating from the descending thoracic aorta.
Findings:
- Femoropopliteal thromboembolectomy restored arterial flow, but the embolic source required further intervention.
- Aortic thromboendarterectomy successfully removed the aortic thrombus, resolving the cause of recurrent embolism.
Implications:
- Transesophageal echocardiography is crucial for diagnosing thoracic aorta pathologies and identifying aortic thrombi.
- Aggressive surgical management of aortic thrombi in low-risk patients is recommended to prevent recurrent embolic episodes.