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Free‐floating thrombus in stroke patients with nonstenotic internal carotid artery—An ultrasonographic study
Author(s) -
Vassileva Evguenia,
Daskalov Marin,
Stamenova Paraskeva
Publication year - 2015
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22172
Subject(s) - medicine , thrombus , stroke (engine) , stenosis , duplex ultrasonography , internal carotid artery , radiology , cardiology , vascular disease , mechanical engineering , engineering
ABSTRACT Background There are multiple causes of free‐floating thrombus (FFT) formation in carotid arteries. The purpose of this study was to evaluate the incidence and natural history of FFT in nonstenotic internal carotid arteries of patients with acute ischemic stroke. Methods During a 50‐month period, 3,200 consecutive patients with acute ischemic stroke were evaluated for internal carotid artery stenosis and the presence of FFT by color‐coded duplex ultrasonography. Diagnostic workup included brain CT, transthoracic echocardiography, Holter electrocardiogram, and hypercoagulability state evaluation. Results We found an FFT in 5 (0.18%) of 2,757 patients with acute stroke and nonstenotic internal carotid artery (mean age 44 years). The underlying pathology was hypercoagulable state in active pulmonary tuberculosis (n = 1), essential thrombocythemia (n = 1), thrombotic complications of nonstenotic plaques (n = 1), unknown (n = 2). All patients clinically improved under antiplatelet therapy. Follow‐up color‐coded duplex ultrasonography showed complete dissolution of FFT in all cases. There was no stroke recurrence. Conclusions Internal carotid artery FFT could be found in young stroke patients without identifiable arterial disease and could be resolved with antithrombotic treatment © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43 :34–38, 2015