Floating thrombus in the internal carotid artery disclosed by B-mode ultrasonography

Arning, Christian; Herrmann, H. D.

doi:10.1007/bf00314487

Cited by 33 publications

(31 citation statements)

References 17 publications

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“…When using ultrasonography to look for plaques in carotid arteries in patients with acute ischemic stroke, we sometimes encounter mobile carotid plaques [1,2,3,4,5]. This type of mobile plaque is thought to be unstable and associated with recurrent stroke.…”

Section: Introductionmentioning

confidence: 99%

Morphological Classification of Mobile Plaques and Their Association with Early Recurrence of Stroke

et al. 2010

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Background: The present study investigated the frequency and morphological characteristics of carotid mobile plaques and examined the relationship between carotid mobile plaques and recurrent strokes. Methods: The study included 94 consecutive acute stroke patients with large-artery atherosclerosis associated with extracranial carotid stenosis. We investigated the presence of mobile plaques by carotid ultrasonography and classified patients into two groups (mobile group and non-mobile group). We compared backgrounds, MRI and ultrasonographic findings, neurological severity on admission and at discharge, and the rate of early recurrent stroke between both groups. Results: Mobile plaques were detected in 12 patients (12.8%). There were four types of mobile plaques: (1) the jellyfish-type plaque, in which the fibrous cap fluctuated like a jellyfish; (2) the streaming-band-type plaque, in which the string attached to the plaque was swaying; (3) the mobile-thrombus-type plaque, in which a mobile mass was attached to the plaque surface, and (4) the fluctuating-ulcer-type plaque, which contained a mobile substance in the plaque ulcer. Although National Institutes of Health Stroke Scale (NIHSS) scores on admission were less severe in the mobile group than in the non-mobile group (median 1 vs. 4, respectively; p = 0.004), the rate of early recurrent stroke was significantly higher in the mobile group than in the non-mobile group (33.3 vs. 7.3%, respectively; p = 0.022). There were no significant differences in NIHSS scores at discharge between groups. Conclusions: Morphologically, several types of mobile plaques were detected in consecutive patients with acute stroke associated with carotid stenosis. Mobile plaques are strongly associated with an early recurrence of stroke.

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Section: Introductionmentioning

confidence: 99%

Morphological Classification of Mobile Plaques and Their Association with Early Recurrence of Stroke

et al. 2010

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“…These types of soft plaques are much more often found during B-mode imaging than intraluminal throm bi, suggesting that thrombi attached to the vessel wall or to a small plaque may be more frequent than assumed [17], Our 6 patients were selected because angiography and microscopic examination confirming intraluminal thrombus were available. Floating thrombi oscillate syn chronously with the rhythm of the cardiac cycle [9,18].…”

Section: Discussionmentioning

confidence: 99%

“…These plaques are not detectable by conventional CW-Doppler sonography [7,8]. High-resolution B-mode imaging techniques, how ever, allow the precise visualization of minor plaques and even fresh thrombi with very low echogenity [9][10][11][12], Four patients illustrate the morphology of intraluminal thrombi detected during B-mode imaging and attached to small plaques of the ICA which cannot be detected by conventional CW-Doppler sonography. The diagnosis of an intraluminal thrombus 4s only seldom made.…”

Section: Introductionmentioning

confidence: 99%

B-Mode Imaging of Intraluminal Thrombus of the Internal Carotid Artery

Weiller¹,

Reinartz²,

Füzesi³

et al. 1991

Cerebrovasc Dis

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Six patients with the diagnosis of intraluminal thrombus of the internal carotid artery are reported. In the first 2 patients with large thrombi, CW-Doppler sonography, B-mode scanning, and histological findings were in agreement The third patient had CW-Doppler and B-mode sonographical findings of a large intraluminal thrombus immediately before an embolic cerebral infarct. Three weeks later, angiography showed a plaque with only an excavation remaining. Another patient had an intraluminal thrombus superimposed on a nonstenosing plaque which was not detected by CW-Doppler sonography but could be identified during B-mode scanning. Angiography and pathoanatomy were confirmative. The fifth patient with B-mode visualization of an echolucent intraluminal structure did not show any thrombus intraoperatively. The sixth patient is reported to demonstrate the failure of B-mode imaging as well as angiography in detecting clots which were found pathoanatomically. Intraluminal thrombi as potential sources of brain embolism can be attached to atherosclerotic plaques of any degree of stenosis. Nonstenosing lesions with an attached thrombus may escape CW-Doppler sonography and even angiography but may be shown during high-resolution B-mode imaging. False-positive findings, however, cannot be avoided. Plaques with thrombi may cause strokes more frequently than assumed.

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“…There have been numerous case series publications describing FFT using various modalities mostly including angiography, duplex ultrasound (DU), and more recently computed tomography (CT). Based on retrospective studies, its incidence is estimated to be between 0.4-0.7 % and 0.05 % at cerebral angiography and DU, respectively [2][3][4]. A more recent single-center retrospective analysis using CT angiography (CTA) quoted the incidence at 3.1 % [5].…”

Section: Introductionmentioning

confidence: 99%

Computed tomography angiography evaluation of internal carotid artery free-floating thrombus—single-center diagnosis, false-positives, and follow-up

et al. 2012

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Floating thrombus in the internal carotid artery disclosed by B-mode ultrasonography

Cited by 33 publications

References 17 publications

Morphological Classification of Mobile Plaques and Their Association with Early Recurrence of Stroke

Morphological Classification of Mobile Plaques and Their Association with Early Recurrence of Stroke

B-Mode Imaging of Intraluminal Thrombus of the Internal Carotid Artery

Computed tomography angiography evaluation of internal carotid artery free-floating thrombus—single-center diagnosis, false-positives, and follow-up

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