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(Circulation. 1996;93:1471.)
© 1996 American Heart Association, Inc.

Articles

Intra-aortic Thrombus Producing Embolic Arterial Vascular Disease

P. Lozano, MD; E. Al Mousa, MD; C.F. Wei, MD; F.T. Thandroyen, MD

From the University of Texas Medical School at Houston and Lyndon B. Johnson Hospital, Division of Cardiology.

Correspondence to F.T. Thandroyen, Lyndon B. Johnson Hospital, Department of Internal Medicine, 4PO-30 012H, 5656 Kelley, Houston, TX 77026.

	Introduction

 
A 45-year-old man presented with acute onset of claudication of the lower limbs and abdominal pain. Echocardiography of the heart was normal. Intra-aortic thrombi were considered to be the source of emboli producing arterial vascular occlusion, splenic infarction, and renal infarction.

View larger version (147K): [in this window] [in a new window]   Figure 1. Top left, Abdominal aortogram showing occlusion (white arrows) of external and internal iliac arteries with extensive collateral circulation. In addition, a filling defect (black arrow) is visualized proximal to the bifurcation of the abdominal aorta. The filling defect most likely represents an intra-aortic thrombus.

View larger version (55K): [in this window] [in a new window]   Figure 2. Top middle and right, Contrast-enhanced abdominal computerized tomographic scans show multiple large hypodense areas in the spleen (middle) in keeping with multiple splenic infarcts. In addition, there are multiple hypodense areas in the kidneys (right) in keeping with multiple renal infarcts.

View larger version (159K): [in this window] [in a new window]   Figure 3. Bottom, Transesophageal two-dimensional echocardiographic images of the descending thoracic aorta are shown in two planes. Left, Short-axis image at 0° illustrates a large intra-aortic mass (12 mm) attached to a plaque (P) on the wall. Right, Long-axis plane at 111°C illustrates the above-mentioned intra-aortic mass arising from the plaque (P) on the wall. In addition, a second multilobulated mass arising from the wall of the aorta is seen. The intra-aortic masses are in keeping with intra-aortic thrombi.

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation . . . [Full Text of this Article]

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