2018 Volume 40 Issue 1 Pages 19-23
On this occasion, we report a rare case of cardiac embolization caused by a free-floating thrombus (FFT) at the kinking of internal carotid artery (ICA). A 79-year-old male patient was admitted in our department, with JCS I-3, total aphasia, NIHSS 14, and atrial fibrillation. Initially performed MRI showed multiple cerebral infarction in the region of left ICA. Ultrasonography showed FFT and severe stenosis at the origin of ICA. Angiography showed bilateral ICA kinking, FFT, and little anterograde blood flow. In order to prevent the progression of infarction, we performed endovascular thrombectomy under proximal balloon occlusion. On the first postoperative day, we found no signs of infarction progression, and the patient was discharged 8 days later. ICA kinking is not rare, but the situation antero-grade blood flow coexist with trapped FFT at ICA is very rare. We suspect the pathogenic mechanism that kinking artery reduced the lumen diameter.
