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.