An embolizing lesion in a minimally diseased aorta

A case report of a patient with an unusual source of emboli resulting in acute limb-threatening ischemia is presented. Diagnostic angiography of the lower extremity was performed, followed by thromboembolectomy, which successfully restored normal arterial flow to the threatened leg. After surgery the patient underwent transesophageal echocardiography, which failed to identify an embolic source. Because of the high degree of clinical suspicion that the primary disease process was embolic rather than thrombotic, a thorough evaluation of the arterial tree was performed, including computed tomography and aortography. A large, mobile intravascular lesion arising from a normal descending thoracic aorta was identified and successfully treated with resection and graft placement.