Abstract
Thromboembolic events following aortic surgery are rare but can have disastrous consequences for the patient. This case report presents a late thromboembolic neurologic event due to a severely kinked ascending aorta prosthetic graft. A 43-year-old male with vascular Ehlers-Danlos syndrome presents with a cerebellar stroke 5 years after a type A aortic dissection repair. Imaging revealed a thrombus in the distal ascending aorta and left common carotid artery that was suspected to have migrated from a severe kink in the ascending aorta prosthesis. Thrombolysis successfully dissolved the thrombus, but during a subsequent redo surgery for post dissection dilatation, new clots were observed at the kinked prosthesis. This case highlights the risks associated with prosthetic kinking, its implications for thrombus formation, and the necessity of vigilant surveillance and possible (medical) intervention to prevent severe thromboembolic events.