Successful Surgical Management of a Giant Floating Aortic Thrombus Causing Acute Upper Limb Ischaemia: A Case Report Publisher



Moayerifar M ; Eftekhari B ; Khalili A ; Stoica S ; Gholipour M
Source: European Heart Journal - Case Reports Published:2026

Abstract

Background: Aortic thrombi are rare and pose clinical challenges as they often remain undetected until embolic complications occur. Case summary: We present the case of a 43-year-old male with acute limb ischaemia, revealed to be due to a large mobile thrombus (measuring 53 × 13 mm) extending from the ascending to descending aorta. The obstruction in the peripheral arteries was managed through mechanical thrombectomy, while the intra-aortic thrombus required surgical intervention. Following these procedures, the patient was put on Apixaban, and no signs of recurrence appeared in subsequent follow-up assessments. Discussion: Timely diagnosis of aortic thrombi is essential to prevent embolic events. Large floating thrombi are rare in healthy young individuals with no pre-existing conditions, especially when causing only upper limb ischaemia. Prompt surgical intervention is recommended to treat and prevent recurrence. Conclusion: While various strategies exist for dealing with large floating thrombi, prioritizing surgical intervention is essential to prevent potential future recurrences. © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.