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A Case of Coincidental Free Floating Thrombus in the Vertebral Artery in a Patient Presenting with an Anterior Circulation Stroke and Literature Review

Neurointervention 2020년 15권 3호 p.144 ~ 153
Al-Jehani Hosam, Alhamid May Adel, Alkhalaf Yousef, Alabbas Faisal,
소속 상세정보
 ( Al-Jehani Hosam ) - Imam Abdulrahman Bin Faisal University King Fahad Hospital of The University Department of Neurosurgery, Interventional Radiology
 ( Alhamid May Adel ) - Imam Abdulrahman Bin Faisal University King Fahad Hospital of The University Department of Neurology, Interventional Radiology
 ( Alkhalaf Yousef ) - Royal Commision Hospital Department of Medicine
 ( Alabbas Faisal ) - Imam Abdulrahman Bin Faisal University King Fahad Hospital of The University Department of Neurosurgery, Interventional Radiology

Abstract


Free-floating thrombus (FFT) is a rare condition with unknown etiology as described by many case reports presented in previous literature. The patients usually present symptomatically while the other few patients remain asymptomatic and are usually discovered incidentally on computed tomography angiography (CTA). Most of the cases reported in the literature are of FFT in the internal carotid artery. We present a 59-year-old female as a case of FFT in the vertebral artery which was coincidently discovered on CTA in a patient initially presenting with an anterior circulation stroke. This case highlights the importance of early contrast-based vascular imaging in patients presenting with large vessel strokes that are cardioembolic in nature and the unique utilization of a direct aspiration first pass technique (ADAPT) for revascularization. Included herein an extensive review of the literature about the decision making in patients with FFT and a devised proposed practical approach to this entity.

키워드

Free-floating thrombus; Vertebral artery; Middle cerebral artery; Acute ischemic stroke; Thrombectomy

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