LOCALIZED THROMBUS IN THE DISTAL AORTIC-ARCH - ITS ETIOLOGY ANALYZED BY 3-DIMENSIONAL MOLD MODEL OF THE THORACIC AORTA

Isolated thrombus of the thoracic aorta without aneurysmal change or d issection is a relatively rare event. A case presenting with aortic th rombus and successive distal embolism is reported herein and the aetio logy of the thrombus of the distal aortic arch is analysed by a three dimensional aortic model. A 61-year-old man suffered acute ischaemia i n his right leg on January 26, 1994. Enhanced computed tomography (CT) showed a localized thrombus in the distal aortic arch expanding towar ds the descending aorta, and partial infarction of the left kidney and the spleen. Angiography demonstrated abrupt occlusion of the right su perficial femoral artery. Immediate anticoagulation with heparin and c oumadin was administered, and the thrombus in the aorta disappeared fo llowing 1 month of this medical treatment, leaving the renal and splen ic infarction unchanged. The unresolved occlusion of the superficial f emoral artery and the popliteal artery was treated with a bypass from the right superficial femoral artery to the peroneal artery using a re versed saphenous Vein graft. The mould model of the thoracic aorta was reconstructed from CT, and the thrombus was found to be at the most d istal and medial site of the lesser curvature of the aortic arch. This specific location is referred mostly as the site for thrombus formati on in the literature. The case is reported briefly and the risk of thi s specific region of the thoracic aorta for thrombus formation is disc ussed using this mold model.