ABSTRACT
A 51-year-old man was referred to our hospital with pain and coldness of the upper left extremity. Contrasted computed tomography revealed a silhouette protruding into the aortic arch. Peripheral embolism in upper left extremity by tumor or thrombosis was suspected. Magnetic resonance imaging revealed a mobile mass in the aortic arch. To prevent recurrent embolization, the mass and the aortic arch to which the mass was attached were excised and partial arch replacement was performed under cardiopulmonary bypass. Histologically, the mass was a fibrin thrombus with no malignancy. The aortic wall showed only mild atherosclerosis of the intima. No thrombotic predisposition such as protein S or C deficiency or antiphospholipid antibody syndrome was observed. Anticoagulant therapy was started and the patient was discharged on postoperative day 10 without recurrent thromboembolism. Three years have passed since the operation and there is no recurrence of thromboembolism.
ABSTRACT
<p>We report a rare case of a large thrombus in the ascending aorta with acute arterial occlusive disease. A 61-year-old man was transferred to our hospital with sudden pain and cyanosis. Contrast-enhanced computed tomography detected left ulnar arterial occlusion and a large mass in the ascending aorta, so we performed surgery to remove the large thrombus under cardiopulmonary bypass. Histologically, the mass was a fibrin thrombus. In addition, thickened endothelial lining and slight atheromatous degeneration was detected in the resected aortic wall. The patient was discharged from the hospital on postoperative day 22.</p>
ABSTRACT
A 49-year-old man complaining of nausea and vomiting was admitted to our hospital for the examinations. Blood tests demonstrated anemia due to iron deficiency and slightly elevated D-dimer. Colonoscopy defected early stage sigmoid colon cancer. Enhanced systemic computed tomography revealed that a 5-cm-long mass was growing along the descending aortic lumen and that multi-embolism had occurred in the peripheral arteries. The limited graft replacement of the descending aorta was carried out under cardiopulmonary bypass to prevent recurrent embolism. Histologically, the mass was a blood clot. In addition, the thickened endothelial lining and slight atheromatous degeneration was detected in the resected aortic wall. The patient was discharged after endoscopic mucosal resection for the sigmoid colon cancer. During the two-year follow-up period, despite no anticoagulation, the patient has developed no thrombus in the aorta and suffered no embolic events.