Free-floating thrombus in the internal carotid artery treated by anticoagulation and delayed carotid endarterectomy

Česká verzia

Authors: M. Leško ml. ¹; I. Guňka ¹; Miroslav Lojík ² ; D. Krajíčková ³
Authors place of work: Chirurgická klinika FN Hradec Králové, přednosta: MUDr. M. Leško, Ph. D. ¹; Radiologická klinika FN Hradec Králové, přednosta: prof. MUDr. A. Krajina, CSc. ²; Neurologická klinika FN Hradec Králové, přednosta: doc. MUDr. M. Vališ, Ph. D. ³
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 8, s. 325-328.
Category: Kazuistika

Summary

Free-floating thrombus in the internal carotid artery is a rare clinical finding. Only case reports and small cohorts of patients are described in the literature. The authors present a case report of a patient with ischemic stroke due to arterio-arterial embolisation from ulcerated internal carotid artery stenosis with a free-floating thrombus. Initially, the patient was treated with anticoagulants, resulting in total dissolution of the free-floating thrombus based on ultrasound documentation, without any further symptomatic embolisation. Endarterectomy was performed in the second step for the critical stenosis of the internal carotid artery. After this combined treatment, the patient showed no neurological deficit. Currently, the opinion on optimal therapy of the free-floating thrombus in the internal carotid artery still remains unclear.

Key words:
free-floating thrombus – anticoagulation − internal carotid artery

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