Surgical management of a mobile floating carotid plaque

A mobile floating carotid plaque (MFCP) is an infrequent pathological lesion with an unknown natural history caused by thinning and rupture of the fibrous cap of the atheromatous plaque; it may result in repeated ischaemic strokes. Duplex carotid ultrasound is a non-invasive technique useful in defining the plaque morphology with high sensitivity and specificity. Due to the lack of evidence, treatment remains controversial. We present a patient with an asymptomatic MFCP diagnosed by ultrasound and treated with carotid endarterectomy without neurological complications due to the procedure and without restenosis nor residual flaps during the follow-up.