Emergency Management of Free-Floating Thrombus in the Internal Carotid Artery Coupled with Thrombotic Enlarged Carotid Bulbous via Overlapped MicroNet™- covered stents

Francesco De Santis*, Cristina Margot Chaves, Roberto Chiappa and Massimiliano Millarelli

Department of Vascular Surgery, Sandro Pertini Hospital, Italy

^*Correspondance to: Francesco De Santis 

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Abstract:

Purpose: Free-floating thrombus in the carotid artery represents an uncommon but challenging pathological condition associated with a high short-term risk of recurrent embolic ischemic events. The aim of this report is to present a unique case of symptomatic free-floating thrombus in the internal carotid artery, developed in the presence of an extensive thrombosis of an enlarged carotid bulbous successfully treated in emergency via two overlapped MicroNet™ covered-stents. Case Report: A 65-year-old male presented with a transient ischemic attack characterized by left hemiparesis. Color-duplex sonography and CT-angiography evidenced a free-floating thrombus extending into the lumen of the proximal right internal carotid artery associated with moderate arterial stenosis and an extensive parietal thrombosis in an enlarged carotid bulbous. No acute cerebral ischemic lesions were detected. Two MicroNet(TM)-covered stents (CGuard™ CGuard™, InspireMD, 9x40mm and 10x40mm) were overlapped at the level of the enlarged carotid bulbous from the distal common to the internal carotid artery. Neurological symptoms completely recovered in 24 h. At six-month follow-up, Eco-color-Doppler ultrasound control confirmed the correct positioning of the stents. Conclusion: Carotid artery stenting via MIcroNet™-covered stents might represent the more suitable endovascular option in symptomatic free-floating thrombus in the carotid artery.

Keywords:

Free- loating thrombus; Internal carotid artery; Carotid artery stenting; MicroNet™ , Mesh stent, Enlarged carotid bulbous; Transient ischemic attack

Cite the Article:

De Santis F, Chaves CM, Chiappa R, Millarelli M. Emergency Management of Free-Floating Thrombus in the Internal Carotid Artery Coupled with Thrombotic Enlarged Carotid Bulbous via Overlapped MicroNet™- covered stents. Ann Clin Case Rep. 2022; 7: 2167..