Free-floating thrombus of the carotid artery: Literature review and case reports

Abstract

FFT is more frequently reported in men than women, with a ratio of nearly 2:1 (P < .0001), and at a younger age than in most patients with carotid disease (P < .0001 when compared with North American Symptomatic Carotid Endarterectomy Trial, European Carotid Surgery Trial, and Asymptomatic Carotid Surgery Trial). Symptoms are present in 92% of patients. There was a trend for patients with FFT to be hypercoagulable (47% of those serologically tested). The internal carotid artery was the most commonly affected (75%), with atherosclerosis being the most common associated pathology. Medical and surgical management have both been used, with neither clearly superior to the other. Medical management for stabilizing neurologic deficits has less risk and less benefit than surgical intervention.

Idiopathic floating thrombus of the common carotid artery: Diagnosis and treatment options

“…The main risk attached to these lesions is the possibility of cerebral embolism caused by detachment of clot fragments. In 75% of all cases, the thrombus develops in the internal carotid [4]. In the other 25%, the common carotid is involved, as it was in our patient.…”

“…In the vast majority of cases (92%) [4], the diagnosis is made after the patient develops clinical signs of cerebral ischemia. The main risk attached to these lesions is the possibility of cerebral embolism caused by detachment of clot fragments.…”

“…The choice of treatment is often difficult: the patient almost always presents signs of an acute ischemic stroke, and there are no standard guidelines on the way these cases should be managed [4].…”

Case of symptomatic mobile atheromatous plaque (MAP) at origin of internal carotid artery and management discussion: A case report

“…ultimately demonstrated both medical and surgical management as being used in the treatment of MAPs, with neither being deemed as superior [1]. Meanwhile, for symptomatic lesions specifically described as mobile plaques, Ko et al, reported two cases with symptomatic MAP that were treated with ticlodipine 200mg daily [6,7].…”

“…A mobile atheromatous floating carotid plaque is an infrequent pathology, which occurs due to unknown mechanisms, and is often responsible for drastic outcomes [1]. Diagnostic imaging demonstrating mobile atheromatous plaque (MAP) at the carotid bifurcation or at the origin of the internal carotid artery (ICA) is a rare finding [2].…”