Republished: Stentriever thrombectomy with distal protection device for carotid free floating thrombus: a technical case report

Giragani, Suresh; Balani, Ankit; Agrawal, Vikas

doi:10.1136/neurintsurg-2016-012904.rep

Cited by 20 publications

(14 citation statements)

References 12 publications

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“…Surgical treatment offers the potential advantage of a definitive treatment for the FFT via embolectomy and also the underlying pathology via endarterectomy in cases of atherosclerosis. Endovascular treatment options have more recently been shown to be effective in the management of FFT [ 13 – 15 ]. Potential advantages of the endovascular approach compared to the standard vascular surgical approach include shorter procedure times with minimal vascular manipulation, which has the potential for dislodging the FFT, but still having the potential to cover the FFT en bloc.…”

Section: Discussionmentioning

confidence: 99%

“…Mechanical thrombectomy, using either aspiration or stent-retrievers, can also be performed and several cases have been published [ 13 , 15 , 18 ]. In the small series ( n = 3) presented by Fitzpatrick et al.…”

Section: Discussionmentioning

confidence: 99%

“…Using this technique the authors successfully retrieved all the clots, with no migration into the intracranial circulation with a maximum of two passes. Giragani et al [ 13 ] described a similar approach, combining a distal filter wire and stent-retriever. In this case, despite medical treatment with antiplatelets and anticoagulants, the patient continued to have TIA and therefore, a more definite option was considered.…”

Section: Discussionmentioning

confidence: 99%

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Carotid Stenting as Definitive Treatment for Free Floating Thrombus—Review of 7 Cases

et al. 2020

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Background and Purpose Free floating thrombus (FFT) is a rare condition. The optimal treatment strategy is yet to be determined although medical management with anticoagulation is the mainstay. This article reports experience of treating FFT with carotid stenting. Methods A retrospective analysis of a prospectively maintained database was performed to identify all patients with FFT treated with carotid stenting. For each patient the demographic data, clinical presentation, location of the thrombus, type of stent and use of adjunctive devices, e.g. balloon guide catheters, clinical and radiological follow-up information as well as complications were recorded. Results A total of 7 patients, 4 female, with mean age of 55.6 ± 14.5 years were identified. The median National Institutes of Health Stroke Scale (NIHSS) was 7 (range 0-13) at presentation. Free floating thrombus was seen on the left in the majority of cases (n = 6, 85.7%). None of the patients had intracranial large vessel occlusion. The FFT was located in the CCA in 2 cases (28.6%) and the proximal ICA in the remaining 5 cases (71.4%). The Wallstent was used in 5 patients and a cGuard stent used in 2 patients. In 1 patient 2 overlapping stents were used but a single stent was used in the remaining patients. In 6 cases a distal filter wire was used and in 2 cases a balloon guide catheter was used as embolic protection. There were no intraoperative complications and no cases of distal clot migration or intracranial large vessel occlusion during the procedure. At last follow-up (n = 7) 6 patients were recorded as modified Rankin Scale (mRS) Ä2 and 1 patient was mRS 3. Conclusion Free floating thrombus of the carotid arteries can be managed with stenting.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Carotid Stenting as Definitive Treatment for Free Floating Thrombus—Review of 7 Cases

et al. 2020

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“…There is no consensus of the management protocol for FFT. We summarized the existing literature on this entity in Table 1 [ 3 , 7 , 8 , 12 , 16 - 41 ]. Although it is difficult to establish a consensus on a management approach for FFT, we devised as proposed practical approach to FFT in a decision tree presented in Fig.…”

Section: Discussionmentioning

confidence: 99%

“…Many case-reports have reported the occurrence of FFT in the carotid artery, mostly the internal carotid artery (ICA). Such patients usually present with a neurological deficit as a consequence of completed stroke with fixed deficits, stroke-in-evolution, or transient ischemic attacks (TIAs) [ 3 ]. A few asymptomatic cases have also been reported.…”

Section: Introductionmentioning

confidence: 99%

A Case of Coincidental Free Floating Thrombus in the Vertebral Artery in a Patient Presenting with an Anterior Circulation Stroke and Literature Review

et al. 2020

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Free-floating thrombus (FFT) is a rare condition with unknown etiology as described by many case reports presented in previous literature. The patients usually present symptomatically while the other few patients remain asymptomatic and are usually discovered incidentally on computed tomography angiography (CTA). Most of the cases reported in the literature are of FFT in the internal carotid artery. We present a 59-year-old female as a case of FFT in the vertebral artery which was coincidently discovered on CTA in a patient initially presenting with an anterior circulation stroke. This case highlights the importance of early contrast-based vascular imaging in patients presenting with large vessel strokes that are cardioembolic in nature and the unique utilization of a direct aspiration first pass technique (ADAPT) for revascularization. Included herein an extensive review of the literature about the decision making in patients with FFT and a devised proposed practical approach to this entity.

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Endovascular aspiration of a symptomatic free-floating common carotid artery thrombus

et al. 2018

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Free-floating thrombi of the common carotid artery (CCA) are a very rare cause of ischemic stroke. To date, only a few reports have been described in the academic literature. Revascularization is indicated due to the risk of thromboembolic disease and hemodynamic-related stroke syndromes. Medical treatment typically includes anticoagulation and, in some circumstances, open surgical thrombectomy is an additional option. Although rarely described in the literature, endovascular thrombectomy is a viable treatment alternative in these patients.

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Republished: Stentriever thrombectomy with distal protection device for carotid free floating thrombus: a technical case report

Cited by 20 publications

References 12 publications

Carotid Stenting as Definitive Treatment for Free Floating Thrombus—Review of 7 Cases

Carotid Stenting as Definitive Treatment for Free Floating Thrombus—Review of 7 Cases

A Case of Coincidental Free Floating Thrombus in the Vertebral Artery in a Patient Presenting with an Anterior Circulation Stroke and Literature Review

Endovascular aspiration of a symptomatic free-floating common carotid artery thrombus

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