2021 Volume 70 Issue 1 Pages 160-166
The patient was a male in his 70s. He felt lightheadedness and heaviness in the head. A mobile plaque was found in the right subclavian artery in a previous hospital, and he was referred to our hospital. Electrocardiogram (ECG) revealed a sinus rhythm, Holter ECG did not indicate atrial fibrillation, and transthoracic echocardiography did not indicate any abnormal structures in the heart that could be suspected of thrombus or vegetation. Carotid echo showed a mobile plaque at the origin of the right subclavian artery, as pointed out by his previous physician, but further observation of the central side revealed a mobile plaque in the brachiocephalic artery. Contrast-enhanced CT showed calcification from the brachiocephalic artery to the right subclavian artery, and the latter was narrowed, but the mobile plaque could not be evaluated. Mobile plaque is a rare condition, and there have been very few reports on mobile plaques in the brachiocephalic or subclavian arteries. In this patient, a careful observation by ultrasonography showed that mobile plaques could be detected in the brachiocephalic artery and right subclavian artery. Ultrasonography is simple and noninvasive and can be used to evaluate the presence, properties, and mobility of intravascular plaques. The brachiocephalic artery and right subclavian artery can often be adequately observed and evaluated by ultrasonography. In general, mobile lesions are difficult to detect by CT or MRI; however, ultrasonography enables the real-time observation of plaques and appears to be the most useful for evaluating mobile plaques.
