title: Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography.
abstract: Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., "CCA stump syndrome." Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan. Electronic address: s-omoto@jikei.ac.jp.
authors: Shusaku
authors: S
authors: Omoto
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Yuki
authors: Y
authors: Hasegawa
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Kenichiro
authors: K
authors: Sakai
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Hiromasa
authors: H
authors: Matsuno
authors: Department of Radiology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Ayumi
authors: A
authors: Arai
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Yuka
authors: Y
authors: Terasawa
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Hidetaka
authors: H
authors: Mitsumura
authors: Department of Neurology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
authors: Yasuyuki
authors: Y
authors: Iguchi
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D002341:Carotid Artery Thrombosis; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002908:Chronic Disease; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging; D004359:Drug Therapy, Combination; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D020766:Intracranial Embolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012008:Recurrence; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: Common carotid artery; mobile thrombus; occlusion; stump syndrome; ultrasonography