Thoracic endovascular aortic repair for descending thoracic aortic thrombus of a patient with Tolosa-Hunt syndrome

Descending thoracic aortic thrombus is a rare condition, often identified during the evaluation for an embolic source. The standard treatment is thoracic aortic replacement; however, its high invasiveness limits patient eligibility. Here, we present the case of a 78-year-old male who presented with acute limb ischemia. Contrast-enhanced computed tomography imaging revealed a floating thrombus in the descending aorta. In addition to thrombectomy for limb salvage, treatment targeting the embolic source was necessary. Thoracic endovascular aortic repair was successfully deployed to address the thrombus source. The patient has remained free of recurrent embolic events and has shown stable progress post-procedure.