Mobile aortic arch thrombus: Conservative management with ticlopidine?

Abstract Diffuse aortic atherosclerotic disease (AAD) is now well recognized as a potential source of cerebral and peripheral emboli. Its clinical importance has been demonstrated in patients over 60. We focus on an unusual presentation of AAD in younger patients free from significant diffuse aortic atherosclerosis, where the outstanding lesion was a large and highly mobile thrombus. Two cases of mobile aortic thrombi, which were conservatively managed with ticlopidine, a potent antiplatelet agent, are reported. Our two cases suggest a possible place of antiplatelet therapy with thienopyridine in the management of isolated large mobile aortic thrombus.