Incidental finding of a large mobile aortic arch mass during conventional angiography

Thromboembolism occurs commonly in general practice and leads to significant health burden. apart from cardiac sources,aortic atherosclerotic plaques contribute considerably to thromboembolism. a 63-year-old diabetic hypertensive woman referred to our center due to exertional chest pain unresponsive to optimal medical therapy and underwent coronary angiography. owing to resistance during guide-wire advancement,an aortography was performed. aortic arch injection demonstrated a large suspended mass distal to the left subclavian artery with free movement in the descending thoracic aorta. echocardiography revealed widespread atherosclerotic changes in the aortic arch with a large hypermobile mass. dual-source multi-slice (2 × 128:256) computed tomography angiography of the whole aorta revealed a large floating mass (in favor of a thrombus) in the distal portion of the arch. the patient underwent coronary artery bypass grafting due to severe coronary artery disease. the intra-aortic mass,which was actually a large atherosclerotic plaque,was resected at the same session. she was discharged uneventfully and during a 1-year follow-up,she had no embolic events. © 2017,tehran heart center. all rights reserved.