Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 May 3;17(1):95.
doi: 10.1186/s13019-022-01843-5.

Fluttering cord-like thrombus in the aortic arch

Yuki Kuroda  1 , Akira Marui  2 , Yoshio Arai  2 , Atsushi Nagasawa  2 , Shinichi Tsumaru  2 , Ryoko Arakaki  2 , Jun Iida  2 , Yuki Wada  2 , Yoshiharu Soga  2
Affiliations
Case Reports

Fluttering cord-like thrombus in the aortic arch

Yuki Kuroda et al. J Cardiothorac Surg. .

Abstract

Background: The optimal treatment for aortic thrombus remains to be determined, but surgical treatment is indicated when there is a risk for thromboembolism.

Case presentation: A 47-year-old male presented with weakness in his left arm upon awakening. Contrast-enhanced computed tomography and transesophageal echocardiography revealed a mobile pedunculated object suggestive of a thrombus arising from the ascending aorta and extending to the left common carotid artery. It was removed under hypothermic circulatory arrest and direct cannulation of the left carotid artery to avoid carotid thromboembolism. Histopathological examination revealed that the object was a thrombus. The patient had an uneventful postoperative course and was discharged 9 days after surgery.

Conclusion: When a thrombus in the aortic arch extends to the neck arteries, direct cannulation of the neck arteries with selective cerebral perfusion via cervical incision is a useful technique.

Keywords: Aortic thrombus; Carotid artery; Case report; Cord-like thrombus; Hypothermic circulatory arrest.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests to disclose.

Figures

Fig. 1
Fig. 1
Contrast-enhanced sagittal oblique view of the thoracic aorta showing intraluminal, hypodense, and linear strands of a non-enhancing structure (red arrows) in the ascending aorta extending to the left common carotid artery (yellow arrow), suggestive of a thrombus
Fig. 2
Fig. 2
Transesophageal echocardiography showing a fluttering cord-like thrombus in the aortic arch extending to the left common carotid artery
Fig. 3
Fig. 3
Specimens of the excised thrombus
See this image and copyright information in PMC

References

    1. Laperche T, Laurian C, Roudaut R, Steg PG. Mobile thromboses of the aortic arch without aortic debris. A transesophageal echocardiographic finding associated with unexplained arterial embolism. The Filiale Echocardiographie de la Société Française de Cardiologie. Circulation. 1997;96:288–294. doi: 10.1161/01.CIR.96.1.288. - DOI - PubMed
    1. Stöllberger C, Kopsa W, Finsterer J. Resolution of an aortic thrombus under anticoagulant therapy. Eur J Cardio-Thoracic Surg. 2001;20:880–882. doi: 10.1016/S1010-7940(01)00902-2. - DOI - PubMed
    1. Maloberti A, Oliva F, De CB, Giannattasio C. Asymptomatic aortic mural thrombus in a minimally atherosclerotic vessel. Interact Cardiovasc Thorac Surg. 2016;22:371–374. doi: 10.1093/icvts/ivv349. - DOI - PMC - PubMed
    1. Scott DJ, White JMAZ. Endovascular management of a mobile thoracic aortic thrombus following recurrent distal thromboembolism: a case report and literature review. Vasc Endovasc Surg. 2014;48:246–250. doi: 10.1177/1538574413513845. - DOI - PubMed
    1. Choi JB, Choi SH, Kim NH, Jeong JW. Floating Thrombus in the Proximal Aortic Arch. Texas Hear Inst J. 2004;31:432–434. - PMC - PubMed

Publication types