Free-floating thrombus (FFT) of the internal carotid artery, which is almost always symptomatic and is usually discovered by ultrasound or angiography performed after a transient cerebrovascular event, is a highly uncommon diagnosis. Here, we report a case of an asymptomatic freefloating internal carotid artery thrombus most probably caused by an atherosclerotic plaque rupture. It was detected by carotid ultrasound and was treated with eversion endarterectomy without any neurologic complications. Six weeks after surgery, the patient is doing well.
1. P. Grzelakowski T. Lugowski M. Kurzyna M. Missima M. Maciejewski M. Balcerzak R. Romanek M. Stelak A. Lugowski A. Goch 2010 Acute intermediate-risk pulmonary embolismwith right-sided freefloating intracardiac thrombus, systemic inflammatory reaction syndrome, multiple organ dysfunction syndrome, disseminated intravascular coagulation and acute ischaemia of a limb Kardiol Pol 68 1140 1144.
2. X. Hou W. Liu Z. Zhang Z. Li 2009 Free-floating right atrial thrombus with acute pulmonary embolism Thorax 64 736.
3. J.C. Parodi B.G. Rubin A. Azizzadeh M. Bartoli G.A. Sicard 2005 Endovascular treatment of an internal carotid artery thrombus using reversal of flow: a case report J Vasc Surg 41 146 150.
4. P.T. Akins S. Glenn P.M. Nemeth C.P. Derdeyn 1996 Carotid artery thrombus associated with severe iron-deficiency anemia and thrombocytosis Stroke 27 1002 1005.
5. A.F. Bhatti L.R. Leon Jr N. Labropoulos T.L. Rubinas H. Rodriguez P.G. Kalman M. Schneck S.B. Psalms J. Biller 2007 Free-floating thrombus of the carotid artery: literature review and case reports J Vasc Surg 45 199 205.
6. E. Ferrero A. Gaggiano M. Ferri F. Nessi 2009 Mobile floating carotid plaque post-trauma. Diagnosis and treatment Interact Cardiovasc Thorac Surg 8 496 497.
7. J.P. Konzen S.R. Levine J.H. Garcia 1995 Vasospasm and thrombus formation as possible mechanisms of stroke related to alkaloidal cocaine Stroke 26 1114 1118.
8. M. Spiegel H. Kopp N. Treese 1994 Extensive aneurysm of the internal carotid artery with free floating round thrombus Vasa 23 367 369.
9. E. Ferrero M. Ferri A. Gaggiano A. Viazzo S. Piazza P. Cumbo G. Berardi F. Nessi 2010 Free floating thrombus developed on a residual carotid intimal flap after carotid endarterectomy. Diagnosis and treatment Ann Vasc Surg 24 573 574.
10. D. Becker P. Maurovich-Horváth B. Merkely 2010 Coronary plaque rupture triggered by electrical cardioversion Interv Med Appl Sci 2 186.
11. J. Biller H.P. Adams Jr D. Boarini J.C. Godersky W.R. Smoker G. Kongable 1986 Intraluminal clot of the carotid artery. A clinical-angiographic correlation of nine patients and literature review Surg Neurol 25 467 477.
12. G.H. Roberson W.R. Scott A.E. Rosenbaum 1973 Thrombi at the site of carotid stenosis. Radiographic diagnosis Radiology 109 353 356.
13. E. Ferrero M. Ferri A. Viazzo C. Labate A. Pecchio G. Berardi S. Piazza P. Cumbo F. Nessi 2011 Free-floating thrombus in the internal carotid artery: diagnosis and treatment of 16 cases in a single center Ann Vasc Surg 25 805 812.
14. C. Arning H.D. Herrmann 1988 Floating thrombus in the internal carotid artery disclosed by B-mode ultrasonography J Neurol 235 425 427.
15. T.R. Lane J. Shalhoub R. Perera A. Mehta M.R. Ellis A. Sandison A.H. Davies I.J. Franklin 2010 Diagnosis and surgicalmanagement of freefloating thrombus within the carotid artery Vasc Endovascular Surg 44 586 593.