https://doi.org/10.4081/btvb.2023.79

Importance of assessment of carotid plaques in the managementof acute ischemic stroke: floating intracarotid plaque

Vol. 2 No. 3 (2023)
Submitted: 10 April 2023
Accepted: 8 August 2023
Published: 6 September 2023
Carotid arterial disease, vulnerable plaque, floating plaque, acute ischemic stroke
Abstract Views: 502
PDF: 134
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Authors

Marwa Eltemamy
marwaeltemamy@yahoo.com
Department of Stroke Medicine, Fairfield General Hospital, United Kingdom.
Robert Namushi
Department of Stroke Medicine, Fairfield General Hospital, United Kingdom.
Narayanamoorthi Saravanan
https://orcid.org/0009-0007-8171-0459
Department of Stroke Medicine, Fairfield General Hospital, United Kingdom.

Mobile atheromatous plaques affecting large arteries are a major risk factor for embolic strokes. We report a case of extensive embolic cerebral infarction secondary to a vulnerable internal carotid artery plaque. A 67-year-old female was admitted with sudden left-sided weakness. A computed tomography brain scan revealed early ischemic changes in the right middle cerebral territory. The ultrasound Doppler showed soft mobile plaque with thrombus in the right internal carotid artery causing 90% stenosis. Magnetic resonance imaging brain scan performed later showed extensive right cerebral infarction. A computed tomography angiogram revealed ulcerated non-occlusive soft tissue plaque in the right internal carotid artery. She was also diagnosed with bladder cancer during this admission and was managed medically due to her performance status. Unstable vulnerable plaques can be symptomatic even in the absence of significant carotid stenosis. Hence, early identification of the plaque vulnerability, using new imaging modalities, and its medical stabilization can help to reduce the risk of cerebrovascular insults. The etiopathogenesis of inflammation within unstable vulnerable plaques and its concordance with inflammatory markers is still unclear. It is feasible in our case the malignantprocess could also be contributing to the inflammation within the blood vessels promoting vulnerability of the plaques.

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How to Cite

Eltemamy, M., Namushi, R., & Saravanan, N. (2023). Importance of assessment of carotid plaques in the managementof acute ischemic stroke: floating intracarotid plaque. Bleeding, Thrombosis and Vascular Biology, 2(3). https://doi.org/10.4081/btvb.2023.79
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