CTICasesMobile Aortic Thrombus Misdiagnosed as Aortic Valve Mass, with Embolization to the Right Axillary Artery
▶ Watch on YouTube — age-restricted, cannot embed here
Imaging findings
A second patient referred with a presumed aortic valve mass was found on retrospectively-gated cine CT to instead have a mobile filling defect in the aortic arch along the lesser curve, inserting just below the left subclavian artery. Serial CTs over several months showed a stable-appearing thrombus on anticoagulation. Less than seven days after acute onset of right arm pain, follow-up imaging showed the thrombus was no longer present at its original site and the right axillary artery was now occluded.
Key takeaways
What was referred as an aortic valve mass was actually a mobile aortic thrombus — cine CT clarified the true location and mobility. The thrombus embolized distally, flipping into the innominate artery before shearing off into the right upper extremity circulation and occluding the right axillary artery, managed with endarterectomy. Histopathology again showed chronic white thrombus. The main imaging differential for a mobile aortic lesion includes intimal sarcoma or tumor invasion.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Diffuse Pulmonary Ossification with Mild FibrosisMetabolic
- Coronary Artery to Coronary Sinus ShuntVascular
- Congenital Fissure Anomalies (Single-Lobed Left Lung, Absent Minor Fissure on Right)Congenital
- T-Cell Lymphoma with Perivascular and Mediastinal InfiltrationNeoplastic
- Cystic Metastasis from Skin Cancer (Angiosarcoma / Basal and Squamous Cell Carcinoma)Neoplastic
- BabesiosisInfection
- Extraskeletal Ewing Sarcoma Metastasis to Pleura and MediastinumNeoplastic
- Neurofibromatosis Type 1 with Extensive Mediastinal NeurofibromasNeoplastic
See all cases from May 29, 2015 →
Related Vascular cases
- Contained Left Ventricular Rupture with Large Thrombus
- Pulmonary Arterial Hypertension (Group 1) in Elderly Patient
- Coiled Ascending Aortic Pseudoaneurysm Post-Dissection Repair
- Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm Post-Mitral Valve Replacement
- Missed Type A Aortic Dissection with Giant Ascending Aortic Aneurysm
- Pulmonary Artery Atherosclerosis in Severe Pulmonary Hypertension