Table 1: Case Reports of patients with embolic strokes in the setting of aortic arch thrombosis in the setting of iron deficiency anemia.

Case reports Demo-
graphics
Past Medical History Location of stroke Aortic Imaging Labs Anemia Workup Treatment Given Outcome

Yakushiji et al (2005)[4]50-year-old womanOccasional hematochezia for 2 months before the admission
Anorexia since the age of 17 years
Left
MCA M1
TEE: mobile mass (18 x 8 mm) in the aortic arch
No atherosclerotic changes on TEE
Hb (g/dl): 5.5 (12-16.5) MCV (microm3): 62 (85-100) Platelet (x1000 microl): 420 (150-350) Iron(microl/dl): 16 (43-172) Ferritin (microl/dl): 21 (0-429) Protein S activity (%): 36 (65-105) Reticulocytes (%): 10 (5-20)Internal hemorrhoidsBlood transfusion
Heparin drip
On day 19 TEE & Cardiac MRI showed resolution of aortic arch clot
Switched to ASA from warfarin at 1 year
On 2-year follow-up, there was no recurrence of IDA or stroke

Yakushiji et al (2005)[4]41-year-old womanEpimenorrhagia since the age of 20 years.Left ACA, Left MCA, Bilateral CerebellumTEE: mobile mass (5 x 10 mm) in the aortic arch.
No atherosclerotic changes on TEE
Hb (g/dl): 7.9 (12-16.5) MCV (microm3): 61 (85-100) Platelet (x1000 microl): 360 (150-350) Iron (microl/dl): 9 (43-172) Ferritin (microl/dl): 2 (0-429)
Protein S activity (%): 54 (65-105) Reticulocytes (%): 23 (5-20)
Adenomyosis uteri.Heparin dripOn day 7 TEE & Cardiac MRI showed resolution of aortic arch clot
On 6-month follow-up, there was no recurrence of IDA or stroke
Switched to ASA from warfarin at 1 year

Bukharovich et al (2012)[2]49-year-old Caucasian womanMenorrhagiaRight sided multiple infarctsTEE: mobile mass (10 x 6 mm) in the aortic arch.
No atherosclerotic changes on TEE
Hb (g/dl): 8.4 (12-16.5) MCV (microm3): 68 (85-100) Platelet (x1000 microl): 567 (150-350) Iron(microl/dl): 20 (43-172) Ferritin (microl/dl): 15 (0-429)No GI source
Negative gynecological evaluation
Heparin drip
Oral Iron
Discharged after 10 days on Warfarin

Ishii et al (2017) [3]41-year-old womanAffective DisorderLeft M 2TEE: mobile mass (10 x 6 mm) in the aortic arch.
No atherosclerotic changes on TEE
Hb (g/dl): 7.5 (12-16.5)Whole-body MRI: Uterine fibroids and endometrial cystsTotal arch replacement

Abbreviations: MCA: middle cerebral artery; ACA: anterior cerebral artery; M1: the proximal segment of middle cerebral artery before bifurcation; M2: a segment of the middle cerebral artery after bifurcation before further subdivision; Hb: hemoglobin; TTE: transesophageal echocardiogram; MRI: magnetic resonance imaging; MCV: mean corpuscular volume.