Abstract
The floating plaque in carotid artery is an uncommon condition that can be detected by a duplex ultrasonography scan and is a high-risk factor for embolic cerebrovascular disease. The histopathological features of floating plaque in carotid artery vary. To the best of our knowledge, there is still considerable controversy about the treatment of floating carotid plaque. In this case, the floating carotid plaque was located in the edge of atherosclerotic plaque in common carotid artery, pathological finding following carotid endarterectomy confirmed that the mobile substances were formed by the contents of the plaque protruding into the carotid lumen after the rupture of the fibrous cap, without mural thrombus. This pathological change was different from those of the mobile substances, which were commonly considered as mural thrombotic substances of ulcer plaque caused by the ruptures of fibrous cap of vulnerable plaque. According to pathological differences, we investigated pathogenesis of ischemic cerebrovascular disease caused by floating carotid plaque and possible treatments.
Highlights
The floating plaques in carotid artery are mobile substances attached to the vessel wall and have reciprocating exercise along with the cardiac cycle detected by ultrasonography
Previous reports believed that the pathological features of the floating plaque were mural thrombotic substances of ulcer plaque caused by the ruptures of fibrous cap of vulnerable plaque [1,2,3,4]
The reports of Stewart et al and Nakajima et al considered that the histopathology of the floating plaque was mural thrombotic substances of ulcer plaque caused by the ruptures of fibrous cap of vulnerable plaque, not fibrin-rich thrombus [1, 4]
Summary
The floating plaques in carotid artery are mobile substances attached to the vessel wall and have reciprocating exercise along with the cardiac cycle detected by ultrasonography. These floating plaques are significantly associated with transient ischemic attack and progressive stroke. Other cases showed that giving anticoagulant therapy, the mobile plaque still progressed and led to recurrent ischemic events in a short time, but there was no pathological evidence of floating plaque [3, 4, 7]. There were no vascular events during a 6-month follow-up period
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