Large thrombus in non-atherosclerotic thoracic ascending aorta as the source of acute upper limb ischemia in a young cocaine user.

OBJECTIVES:We present the case of a young woman cocaine user without other cardiovascular risk factors attended to the emergency service presenting signs of acute arterial ischemia on the right arm. METHODS:An angio-CT of the upper limb was performed, highlighting the occlusion of the radial and ulnar arteries and in addition revealed a floating thrombus in the posterior wall of the aortic arch. RESULTS:The patient underwent urgent surgery with transhumeral thrombectomy and four days later, she underwent surgery to remove the aortic thrombus. CONCLUSIONS:A floating thrombus in a non-atherosclerotic ascending aorta conditioning peripheral embolism with upper limbs ischemia is a very rare entity that has to be evaluated finding and treating the origin of the pathology.