Large thrombus in non-atherosclerotic thoracic ascending aorta as the source of acute upper limb ischemia in a young cocaine user

Abstract

Objectives We present the case of a young woman cocaine user without other cardiovascular risk factors attended to the emergency service presenting signs of acute arterial ischemia on the right arm. Methods An angio-CT of the upper limb was performed, highlighting the occlusion of the radial and ulnar arteries and in addition revealed a floating thrombus in the posterior wall of the aortic arch. Results The patient underwent urgent surgery with transhumeral thrombectomy and four days later, she underwent surgery to remove the aortic thrombus. Conclusions A floating thrombus in a non-atherosclerotic ascending aorta conditioning peripheral embolism with upper limbs ischemia is a very rare entity that has to be evaluated finding and treating the origin of the pathology.