Bilateral intermittent claudication and the aorta.

With the increasing utilization of imaging strategies such as transesophageal echocardiography and magnetic resonance imaging, thrombi of the aorta are becoming increasingly recognized as sources of peripheral emboli. This report describes a 70-year-old man with bilateral intermittent claudication. Arteriography revealed occlusion of the distal part of the right tibialis posterior artery and the left tibialis anterior artery, but no occlusive atherosclerotic disease of the iliac, femoral, or popliteal artery. Additionally, no calcification of the vessels could be demonstrated. In contrast, a giant thrombus of the descending aorta was identified as the source of systemic thromboembolism. The patient was treated successfully with long-term anticoagulation.