title: Acute free-floating carotid artery thrombus causing stroke in a young patient: unique etiology and management using endovascular approach.
abstract: Atherosclerotic disease accounts for 20%-30% of strokes in the general population. In young adults, it is an unexpected event and its causes involve diverse pathologies. Herein, we describe a unique case of acute embolic stroke in a young adult patient due to the presence of a large clot in the right common and internal carotid arteries, as a result of an extrinsic cause. Surgical clot retrieval was considered unsafe at that point in time in view of the active inflammatory changes surrounding the affected vessels. This was eventually treated with a novel endovascular technique, a unique alternative to open surgery, with excellent clinical outcome. To our knowledge, the penumbra system has never been used for thrombus removal in a nonacute setting.
authors.affiliation: Department of Diagnostic Radiology, Neuroscience Centre, Singapore. Electronic address: tan_ai_peng@hotmail.com.
authors.forename: Ai Peng
authors.initials: AP
authors.lastname: Tan
authors.affiliation: Department of Diagnostic Radiology, Neuroscience Centre, Singapore.
authors.forename: Manish
authors.initials: M
authors.lastname: Taneja
authors.affiliation: Department of Diagnostic Radiology, Neuroscience Centre, Singapore.
authors.forename: Boon Heng
authors.initials: BH
authors.lastname: Seah
authors.affiliation: Department of Diagnostic Radiology, Neuroscience Centre, Singapore.
authors.forename: Hoe Nam
authors.initials: HN
authors.lastname: Leong
authors.affiliation: Department of Diagnostic Radiology, Neuroscience Centre, Singapore.
authors.forename: Narayanaswamy
authors.initials: N
authors.lastname: Venketasubramanian
mesh_terms: D015901:Angiography, Digital Subtraction; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D038524:Diffusion Magnetic Resonance Imaging; D057505:Embolic Protection Devices; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D006801:Humans; D008297:Male; D008405:Massage / Q000009:adverse effects*; D008875:Middle Aged; D020521:Stroke / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013396:Suction; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome; D062666:Vascular Access Devices
keywords: Acute embolic stroke; embolectomy; endovascular approach; free floating thrombus; young adults