Key result
Anticoagulation with a combination of warfarin, aspirin, and atorvastatin reduced the size of a mobile aortic arch thrombus from 9.6 mm to 3 mm after 18 months in a patient with recurrent stroke.
Case Report (n=1)
In a patient with recurrent cerebral infarction from a mobile aortic arch thrombus, a combination of warfarin, aspirin, and atorvastatin reduced thrombus size and stabilized the plaque over 18 months.
May support combined antithrombotic-statin therapy for mobile aortic arch thrombus in recurrent stroke; leaves open confirmation in prospective trials.
The mobile thrombus in the aortic arch is a rare condition, which becomes rarer when associated with cerebral infarction, resulting in disabling complications. Transesophageal echocardiography is useful for detecting the source of thrombi in the heart and aortic arch. Here, we report a case of a patient who suffered from recurrent cerebral infarction four times during the previous 18 months due to mobile thrombus in the aortic arch despite anticoagulant therapy. The thrombus with rocking motion (9.6 and 8 mm) was laid in the top of the aortic arch, and surgical resection was not allowed due to the location. We began anticoagulation therapy initially with heparin followed by a combination of warfarin, aspirin, and atorvastatin with an international normalized ratio between 2 and 3. The size of the aortic thrombi was significantly decreased by 3 mm and stabilized after 18 months.
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Bok et al. (2013) conducted a case report in Recurrent cerebral infarction caused by mobile aortic arch thrombus (n=1). Warfarin, aspirin, and atorvastatin combination therapy was evaluated. Anticoagulation with a combination of warfarin, aspirin, and atorvastatin reduced the size of a mobile aortic arch thrombus from 9.6 mm to 3 mm after 18 months in a patient with recurrent stroke.