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Management of mobile floating carotid plaque using carotid artery stenting
Elie Y Chakhtoura1, Jonathan E Goldstein, Robert W Hobson
1Division of Cardiology, St. Michael's Medical Center, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey, USA.
Insights
Mobile floating carotid plaque (MFCP) poses an uncertain stroke risk. Carotid artery stenting effectively treated MFCP in two patients, demonstrating a viable management option with sustained positive outcomes.
Area of Science:
- Vascular Surgery
- Neurology
- Interventional Cardiology
Background:
- Mobile floating carotid plaque (MFCP) presents a diagnostic challenge due to its indeterminate risk of embolic cerebrovascular events.
- Management strategies for MFCP require careful consideration, especially in patients with prior interventions.
Observation:
- Two high-risk patients with a history of carotid endarterectomy were diagnosed with MFCP via duplex ultrasound.
- One patient experienced a transient ischemic attack, while the other was asymptomatic with moderate stenosis.
Findings:
- Both patients underwent successful carotid artery stenting, achieving complete coverage of the MFCP.
- Outcomes were uneventful, with sustained arterial patency observed during 32 and 44 months of event-free survival.
Implications:
- Carotid artery stenting emerges as a potentially effective treatment for MFCP.
- This approach may offer a safe and durable solution for managing patients with mobile floating carotid plaque.
Purpose:
To present management techniques for dealing with mobile floating carotid plaque (MFCP), which represents an indeterminate risk of embolic cerebrovascular events.
Case Reports:
Two high-risk patients with a history of carotid endarterectomy were diagnosed with MFCP by duplex ultrasound scanning. One patient had a left hemispheric transient ischemic attack while the other was asymptomatic with a moderate stenosis. Both were successfully treated with carotid artery stenting, achieving complete coverage of the MFCP. Their outcomes were uneventful, and sustained patency of the stented arteries has been observed during an event-free survival of 32 and 44 months, respectively.
Conclusions:
Based upon the unique nature of these lesions and our satisfactory clinical results, we believe that carotid stenting may be a viable option for the treatment of MFCP.