Free-Floating Thrombus in the Common Carotid Artery

Abstract

Background : Floating thrombus in carotid artery is highly related to the propensity for distal embolization due to its extremely unstable property and is therefore regarded as a threatening condition. Case Descriptions : We describe one patient with multiple cerebral infarction caused by artery to artery emboli. Free-floating thrombus adherent to the plaques was detected in the common carotid artery near carotid bifurcation by carotid duplex ultrasonography. No other embolic source could be found. MRI revealed multiple embolic infarctions in the middle cerebral artery territory. Under the treatment of anticoagulation, there was no recurrence of stroke or transient ischemic attack. The free-floating thrombus disappeared on follow-up carotid duplex ultrasonography. Conclusions : Carotid duplex ultrasonography in acute ischemic stroke is useful for recognizing free-floating thrombus. Treatment under this situation remains controversial, but anticoagulation alone seems to be sufficient to prevent further stroke in our patient without surgical intervention. Korean Journal of Stroke 1999;1(2): 268~270