Stump embolization from an occluded internal carotid artery. Case report

Area of Science:

• Vascular Surgery
• Neurology
• Interventional Cardiology

Background:

• Internal carotid artery (ICA) occlusion can lead to ischemic events.
• Thrombus formation at the ICA stump is a potential complication.
• Atherosclerotic disease is often implicated in cerebrovascular events.

Observation:

• A patient with known ICA occlusion presented with TIAs.
• Arteriography revealed a thrombus originating from the ICA stump.
• The thrombus was not associated with significant atherosclerotic stenosis in adjacent carotid arteries.

Findings:

• The identified thrombus in the ICA stump was the source of embolic TIAs.
• Stump angioplasty and endarterectomy were performed.
• These interventions successfully removed the thrombus and addressed the underlying issue.

Implications:

• Surgical management of ICA stump thrombus can effectively prevent recurrent TIAs.
• This case highlights the importance of evaluating the ICA stump in patients with unexplained TIAs and known occlusion.
• Interventional and surgical approaches offer viable solutions for managing thromboembolic complications from ICA stump disease.