title: Free-floating thrombus of the carotid artery with a homozygous methylenetetrahydrofolate reductase gene mutation: a case report.
abstract: Free-floating thrombus (FFT) of the carotid artery is a rare condition of currently unknown etiology. We describe a symptomatic patient with an FFT in the left common carotid artery. A duplex ultrasonography scan showed the presence of a mobile floating thrombus moving in cyclical motion with the cardiac cycles in the left common carotid artery. During emergency surgery, an FFT was seen at this location and removed. No underlying wall defect was seen at the time of surgery. In a genetic screening test, TT homozygous for the methylenetetrahydrofolate reductase (MTHFR) C677T genetic polymorphisms was detected. The patient recovered uneventfully, with no neurogical events. Lifelong anticoagulant therapy was recommended. An aggressive surgical approach is recommended in the patient to prevent embolic episodes.
authors.affiliation: Department of Cardiovascular Surgery, University of Fatih, Ankara, Turkey. ncolak44@gmail.com
authors.forename: Necmettin
authors.initials: N
authors.lastname: Colak
authors.forename: Yunus
authors.initials: Y
authors.lastname: Nazli
authors.forename: Dilek
authors.initials: D
authors.lastname: Kosehan
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Alpay
authors.forename: Omer
authors.initials: O
authors.lastname: Cakir
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics* / Q000628:therapy; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004252:DNA Mutational Analysis; D020022:Genetic Predisposition to Disease; D006720:Homozygote; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics*; D008875:Middle Aged; D009154:Mutation; D010641:Phenotype; D017131:Thrombectomy; D013927:Thrombosis / Q000175:diagnosis / Q000201:enzymology / Q000235:genetics* / Q000628:therapy; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D000925:Anticoagulants; C573423:MTHFR protein, human; D042965:Methylenetetrahydrofolate Reductase (NADPH2)