Free-floating thrombus of the internal carotid artery

Last revised by Rohit Sharma on 23 May 2022

Free-floating thrombus of the internal carotid artery is an uncommon entity placing the patient at high risk for acute ischemic stroke. It is characterized by intraluminal thrombus within the internal carotid artery (ICA) and aggressively managed with surgical, medical, or combined therapy. 

The true incidence is unknown but estimates range from 0.05% to 0.7%1.

The majority of patients present with acute neurological symptoms concerning for ischemic stroke or transient ischemic attack

Intraluminal thrombus projecting into the internal carotid artery. It is frequently associated with atherosclerotic plaque. The amount of thrombus can range from a small to extensive throughout the ICA. 

Aggressive management with urgent endarterectomy, anticoagulation, or combined medical/surgical approaches have all shown success 1.

ADVERTISEMENT: Supporters see fewer/no ads