Common Carotid Artery Stump Syndrome Due to Mobile Thrombus Detected by Carotid Duplex Ultrasonography

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• 作者：Shusaku Omoto ; MD ; PhD^* ; ^{s-omoto@jikei.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yuki Hasegawa ; MD^* ; Kenichiro Sakai ; MD ; PhD^* ; Hiromasa Matsuno ; MD^* ; Ayumi Arai ; MT^&dagger ; ; Yuka Terasawa ; MD ; PhD^* ; Hidetaka Mitsumura ; MD ; PhD^* ; Yasuyuki Iguchi ; MD ; PhD^*
• 关键词：Common carotid artery ; occlusion ; stump syndrome ; mobile thrombus ; ultrasonography
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：25
• 期：10
• 页码：e205-e207
• 全文大小：262 K

文摘

Carotid stump syndrome is a cause of recurrent embolic stroke following occlusion of the ipsilateral internal carotid artery. The present report describes a case of recurrent cerebral embolism ipsilateral to a chronically occluded left common carotid artery (CCA), i.e., “CCA stump syndrome.” Doppler color flow imaging showed anterograde flow in the left internal and external carotid arteries, which were supplied by collateral flow from the superior thyroid artery inflowing just proximal to the left carotid bifurcation. According to carotid duplex ultrasonography (CDU), a low-echoic mobile thrombus was noted at the distal stump of the occluded CCA, which presumably caused distal embolism. The low-echoic mobile thrombus dramatically changed to a homogenously high-echoic thrombus, and there was no recurrence of stroke after antiplatelet and anticoagulant therapy. This is the first report to demonstrate a CDU-verified temporal change in the thrombus at the stump in CCA stump syndrome. CDU is a noninvasive and useful technique to characterize hemodynamics, thrombus morphology, and the response to therapy.