A Case of Carotid Free-Floating Thrombus Treated by Carotid Ultrasonography-Guided Endovascular Approach

• Published in: Nō shinkei geka Vol. 44; no. 6; p. 489
• Main Authors: Otawa, Masato, Kinkori, Takeshi, Watanabe, Kenichi, Ando, Ryo, Tambara, Masao, Arima, Toru
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-06-2016
• Subjects: Combined Modality Therapy; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neurosurgical Procedures; Stents; Stroke - diagnostic imaging; Stroke - drug therapy; Stroke - pathology; Stroke - surgery; Thrombosis - diagnostic imaging; Thrombosis - drug therapy; Thrombosis - pathology; Thrombosis - surgery
• ISSN: 0301-2603
• DOI: 10.11477/mf.1436203316

We experienced a case of carotid free-floating thrombus treated by carotid ultrasonography-guided endovascular approach. A 63-year-old man was brought to our hospital with the chief complaint of sudden onset left hemiplegia. MRI revealed acute infarction of the right MCA territory due to the right M1 occlusion. Carotid ultrasonography showed a pedunculated, polypoid mobile plaque floating with the cardiac beat. We attempted ultrasonography-guided endovascular treatment. Under proximal balloon protection, the floating plaque was successfully aspirated into the Penumbra aspiration catheter. Carotid stent was also placed to stabilize the residual pedicle of the plaque. Aspirated plaque was identified as fresh thrombus by pathological examination. Carotid ultrasonography-guided endovascular approach was effective for getting the picture of real-time dynamics of the carotid FFT.