Recurrent Cerebral Infarction Caused by Mobile Aortic Arch Thrombus Refractory to Warfarin Therapy.
10.5535/arm.2013.37.5.750
- Author:
Soo Kyung BOK
1
;
Young Jin LEE
;
So Young AHN
Author Information
1. Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea. asyoung@cnuh.co.kr
- Publication Type:Case Report
- Keywords:
Aorta;
Thrombus;
Stroke;
Transesohphageal echocardiography
- MeSH:
Aorta;
Aorta, Thoracic*;
Aspirin;
Cerebral Infarction*;
Echocardiography, Transesophageal;
Heart;
Heparin;
Heptanoic Acids;
Humans;
International Normalized Ratio;
Pyrroles;
Stroke;
Thrombosis*;
Warfarin*;
Atorvastatin Calcium
- From:Annals of Rehabilitation Medicine
2013;37(5):750-754
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
