A Case of Carotid Free-floating Thrombus Longitudinally Extending to the Craniocervical Junction after Intravenous Thrombolytic Therapy for Acute Internal Carotid Artery Occlusion / 内頚動脈閉塞に対する血栓溶解療法後に頭蓋頚椎移行部まで続くcarotid free-floating thrombusを認めた1例
- Resource Type
- Journal Article
- Authors
- Hideyuki TOMITA; Katsuya SAITO; 冨田 栄幸; 斉藤 克也
- Source
- 脳卒中の外科 / Surgery for Cerebral Stroke. 2019, 47(5):385
- Subject
- carotid artery stenosis
carotid endarterectomy
free-floating thrombus
internal carotid artery occlusion
intravenous thrombolytic therapy
- Language
- Japanese
- ISSN
- 0914-5508
1880-4683
Carotid free-floating thrombus (CFFT) is rare with less than 150-200 cases reported in the literature. Most previous reports were related to the spontaneous onset of CFFT. Its etiology was thought to be due to atheromatous plaque complication and hypercoagulable states. We experienced a longitudinally extensive CFFT secondarily generated following intravenous thrombolytic therapy. When reviewing the literature, there was only one other case of CFFT secondarily generated after intravenous thrombolytic therapy. Treatment options of CFFT include medical management and surgical and endovascular thrombectomy. In our case, mechanical thrombectomy was deferred due to an extremely high risk of embolism. Delayed endarterectomy after antithrombotic therapy resulted in a favorable clinical outcome. We report an extremely rare and successful case of longitudinally extensive CFFT, secondarily generated after intravenous thrombolytic therapy.