Embolic strokes in a patient with a large floating thrombus in the ascending aorta.

Background: A floating thrombus in the ascending aorta is a rare finding that may cause multiple ischemic strokes with catastrophic consequences. The treatment algorithm for such lesions is yet to be defined.

Case Report: We report the case of a 50-year-old patient with multiple cerebral ischemic strokes due to a sizeable floating thrombus (25 x 15 x 13 mm) in the ascending aorta. Conservative management utilizing anticoagulants was chosen due to the patient's high estimated perioperative risk.

Conclusion: An anticoagulation treatment strategy may be feasible, safe, and effective in patients with large mobile thrombus in the aorta who are not eligible for thrombectomy. HIPPOKRATIA 2021, 25 (3):172-174.