Symptomatic carotid artery intraluminal thrombus: risk of medical management failure and distal embolization.
Publication/Presentation Date
12-26-2024
Abstract
BACKGROUND: Carotid artery intraluminal thrombus (ILT), or free-floating thrombus, is an uncommon cerebrovascular entity with considerable equipoise regarding its clinical management. Likewise, in patients treated with medical management (MM), distal embolization and/or intracranial hemorrhage (ICH) may still occur.
METHODS: All patients with symptomatic ILT from 2016 to 2023 were identified from our tertiary care institution. Patients with MM failure (recurrent cerebral ischemia and/or symptomatic ICH) were compared with patients with MM non-failure. Differences in ILT volume and length were calculated. Receiver operator characteristic (ROC) curve analysis was used to identify the cut-off volume and length for risk of MM failure.
RESULTS: In total, 45 patients with ILT were identified with 41 treated with frontline MM. Of these 41 patients treated with MM, seven (17%) had MM failure with six (14.6%) having new embolic stroke and one (2.3%) with symptomatic ICH. Patients with MM failure had a significantly higher mean thrombus volume than MM non-failure patients (257 mm
CONCLUSIONS: Carotid ILTs that fail MM are significantly larger and longer. These findings suggest that a thrombus volume of 90 mm
Volume
17
Issue
e1
First Page
55
Last Page
55
ISSN
1759-8486
Published In/Presented At
Schartz, D., Susa, S., Ellens, N., Akkipeddi, S. M. K., Houk, C., Bhalla, T., Mattingly, T., Hasan, D., & Bender, M. T. (2024). Symptomatic carotid artery intraluminal thrombus: risk of medical management failure and distal embolization. Journal of neurointerventional surgery, 17(e1), e55–e59. https://doi.org/10.1136/jnis-2023-021044
Disciplines
Medicine and Health Sciences
PubMedID
38041660
Department(s)
Department of Surgery
Document Type
Article