Disappearing carotid defects

Area of Science:

• Neurology
• Vascular Surgery
• Cardiology

Background:

• Acute hemispheric neurologic episodes can be associated with large intraluminal cervical carotid artery filling defects.
• These defects are consistent with mural thrombi, potentially linked to underlying atheromatous disease.

Observation:

• Serial angiography revealed the disappearance of these mural thrombi in patients.
• Thrombi resolved in two patients treated with intravenous heparin.
• One patient experienced spontaneous resolution after surgical intervention.

Findings:

• Partially obstructing cervical carotid artery thrombi can undergo lysis.
• Resolution can be achieved through anticoagulant therapy (heparin).
• Spontaneous lysis of carotid artery thrombi is also possible.

Implications:

• Intravenous heparin may be a viable treatment for resolving cervical carotid artery thrombi.
• Understanding thrombus resolution mechanisms is crucial for managing cerebrovascular events.
• Atherosclerosis is a potential contributing factor to the formation of these thrombi, highlighting the importance of managing vascular disease.