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We report an incident of a 66-year-old guy in cardiogenic shock, as a result of an ischemic cardiomyopathy, which also had intramural thrombus with an intraluminal element when you look at the descending thoracic aorta. An endovascular stent graft ended up being inserted within the aorta over the located area of the mural thrombus. This permitted for the placement of an intra-aortic balloon pump (IABP) for pre-operative optimization. After