Key result
Anticoagulation resolves a huge pedunculated aortic arch thrombus without thromboembolic recurrence at 12 months.
Case Report (n=1)
No
Medical therapy with anticoagulation can be an effective and safe treatment for huge pedunculated thrombi in the aortic arch causing cerebral embolization.
Anticoagulation may be an option for pedunculated aortic arch thrombi; leaves open need for prospective trials versus surgery.
Pedunculated thrombus in the aortic arch that is associated with cerebral infarction is very rare requires prompt diagnosis and treatment to prevent occurrence of another devastating complication. Transesophageal echocardiography is useful for detecting source of embolism including aortic thrombi. The treatment options of aortic thrombi involves anticoagulation, thrombolysis, thromboaspiration, and thrombectomy. Here we report a case of huge thrombus in the aortic arch, resulting in acute multifocal cerebellar embolic infarct in patient without any risk factors for vascular thrombosis. Thrombi in the aortic arch were diagnosed by transesophageal echocardiography and treated with anticoagulants successfully.
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Song et al. (2009) conducted a case report in Aortic arch thrombus with cerebrovascular embolization (n=1). Anticoagulation therapy (heparin and warfarin) was evaluated on Recurrence of thromboembolic events. Anticoagulation therapy successfully treated a huge pedunculated thrombus in the aortic arch, with no recurrent thromboembolic events observed over a 12-month follow-up period.
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