Aetiology of extracranial carotid free-floating thrombus in a prospective multicentre cohort  

作　　者：Dar Dowlatshahi Cheemun Lum Bijoy K Menon Aditya Bharatha Prasham Dave Paulo Puac-Polanco Dylan Blacquiere Grant Stotts Michel Shamy Franco Momoli Rebecca Thornhill Ronda Lun Carlos Torres 

机构地区：[1]Department of Medicine,University of Ottawa,Ottawa,Ontario,Canada [2]Clinical Epidemiology,Ottawa Hospital Research Institute,Ottawa,Ontario,Canada [3]School of Epidemiology and Public Health,University of Ottawa,Ottawa,Ontario,Canada [4]Department of Radiology,University of Ottawa,Ottawa,Ontario,Canada [5]Departments of Clinical Neurosciences,Radiology and Community Health Sciences,University of Calgary,Calgary,Alberta,Canada [6]Department of Medical Imaging,University of Toronto,Toronto,Ontario,Canada [7]Medicine,Queen's University,Kingston,Ontario,Canada

出　　处：《Stroke & Vascular Neurology》2023年第3期194-196,I0005,共4页卒中与血管神经病学（英文）

基　　金：This study was funded by uOttawa Department of Medicine.

摘　　要：Background Carotid free-floating thrombi(FFT)in patients with acute transient ischaemic attack(TIA)/stroke have a high risk of early recurrent stroke.Management depends on aetiology,which can include local plaque rupture,dissection,coagulopathy,malignancy and cardioembolism.Our objectives were to classify the underlying aetiology of FFT and to estimate the proportion of patients with underlying stenosis requiring revascularisation.Methods We prospectively enrolled consecutive patients presenting to three comprehensive stroke centres with acute TIA/stroke and ipsilateral internal carotid artery FFT.The aetiology of FFT was classified as:carotid atherosclerotic disease,carotid dissection,cardioembolism,both carotid atherosclerosis and cardioembolism,or embolic stroke of uncertain source(ESUS).Patients with carotid atherosclerosis were further subclassified as having≥50%or<50%stenosis.Results We enrolled 83 patients with confirmed FFT.Aetiological assessments revealed 66/83(79.5%)had carotid atherosclerotic plaque,4/83(4.8%)had a carotid dissection,10/83(12%)had both atrial fibrillation and carotid atherosclerotic plaque and 3/83(3.6%)were classified as ESUS.Of the 76 patients with atherosclerotic plaque(including those with atrial fibrillation),40(52.6%)had≥50%ipsilateral stenosis.Conclusions The majority of symptomatic carotid artery FFT are likely caused by local plaque rupture,more than half of which are associated with moderate to severe carotid stenosis requiring revascularisation.However,a significant number of FFTs are caused by non-atherosclerotic mechanisms warranting additional investigations.

关 键 词：CAROTID PROSPECTIVE floating 

分 类 号：R743.3[医药卫生—神经病学与精神病学]