Diagnosis and treatment of free floating thrombus in carotid artery

Abstract

Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery. Methods From Jul 2016 to Oct 2017, 7 patients with free floating thrombus in carotid artery was diagnosed at our department . The medical history, symptoms, diagnosis, treatment strategy and prognosis of those patients were analyzed retrospectively. Results Among 7 patients, 4 were symptomatic; 4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis. 3 received carotid endarterectomy and patch angioplasty. 4 received carotid artery stenting with distal cerebral protection divice. There was no perioperative and 30-day stroke, myocardial infarction, death or hyperperfusion syndrome occurred. The 12-month follow up showed no restenosis, no free floating thrombus recurrence and no ischemic cerebrovascular event. Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque. Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus. Key words: Carotid arteries; Endarterectomy, carotid; Carotid artery stenting; Free-floating plaque