Endovascular Treatment of Acute Stroke due to the Floating Carotid Thrombus with Intra-Arterial Tissue Plasminogen Activator and Stenting

Abstract

54-year-old male patient was admitted to emergency service with bilateral loss of sight, consciousness and a Glasgow Coma Scale score of 15. His neurologic examination revealed no lateralized deficit but left homonymous hemianopia. Brain CT and diffusion MRI showed acute infarction in the right parietal and occipital lobes. There was a wide penumbra region on brain perfusion CT. The selective angiography showed preocclusive stenosis at the origin of right internal carotid artery (ICA) and massive floating thrombus (FT) in the cervical ICA segment. We report successful endovascular treatment of FT in the ICA using intra-arterial tissue plasminogen activator and stenting.