CTICasesThoracic Aortic Mobile Thrombus
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Imaging findings
Contrast-enhanced chest CT reveals a pedunculated, mobile filling defect attached to the wall of the distal aortic arch along its under-surface, adjacent to the ligamentum arteriosum. Minimal atherosclerotic disease is present elsewhere in the aorta. The patient had presented with acute abdominal pain due to distal embolization.
Key takeaways
Thoracic aortic mobile thrombus is a rare but important source of systemic arterial embolization. These thrombi typically arise along the under-surface of the aortic arch, often near the ligamentum arteriosum, even in the absence of significant atherosclerotic plaque. Management is controversial and can range from anticoagulation to surgical thrombectomy.
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