Surgery after anticoagulation in stroke patients with nonatherosclerotic internal carotid artery thrombus: a clinicopathological case series.

摘要

Atherosclerotic internal carotid artery (ICA) stenosis has been addressed by clinical trials and guidelines [for review, see 1]. A few case reports and series exist on ICA thrombi associated with ICA plaques, aneurysms, dissections, and on occlusive thrombosis of the common carotid artery. Very little is known, however, about stroke patients presenting with a fresh, sometimes free-floating, nonstenosing ICA thrombus not associated with relevant atherosclerosis. It is presently unclear whether these patients should be treated surgically or medically only, i.e. by anticoagulation or an-tiaggregation. Here, we report a series of stroke patients with non-atherosclerotic ICA thrombi removed surgically after anticoagulation. We also present a systematic histopathological assessment of all thrombus specimens.