• Akira Sugie, Makoto Yamada, Kunio Yokoyama, Masashi Yamashita, Yutaka Ito, Hidekazu Tanaka, Yukiya Nomura, Masutsugu Fujita, Toshio Nakatani, and Masahiro Kawanishi.
• Department of Neurosurgery, Ijinkai Takeda General Hospital, Kyoto, Japan; Emergency Medical Center, Ijinkai Takeda General Hospital, Kyoto, Japan. Electronic address: neu055@osaka-med.ac.jp.
• World Neurosurg. 2020 Sep 1; 141: 236-239.

BackgroundCarotid free-floating thrombus (CFFT) is defined as a blood clot attached to the arterial wall with surrounding blood flow at its distal component. Although rare, it is a clinically significant cause of embolic stroke. CFFT within a stent has not been previously reported.Case DescriptionWe report a 64-year-old man who underwent carotid artery stenting for asymptomatic right carotid artery stenosis. Six months after carotid artery stenting, he was admitted to the emergency department 1 hour after onset of left hemiparesis and dysarthria. His National Institutes of Health Stroke Scale score was 10. His medical history was notable for hypertension, chronic renal insufficiency, and type 2 diabetes mellitus. Carotid ultrasonography showed a dumbbell-shaped CFFT attached to the carotid stent that was moving in synchrony with his heartbeat. CFFT removal was performed via an endovascular approach with manual suction using a Luer Lock syringe. The CFFT was completely removed without residual stenosis. Histologic examination suggested plaque rupture associated with a lipid-rich necrotic core.ConclusionsCarotid plaque formation and plaque rupture can occur within a carotid stent and present as a CFFT.Copyright © 2020 Elsevier Inc. All rights reserved.

27 keywords...

hide…