Symptomatic Common Carotid Free-Floating Thrombus in a COVID-19 Patient, Case Report and Literature Review

Ann Vasc Surg. 2021 May:73:122-128. doi: 10.1016/j.avsg.2021.02.008. Epub 2021 Mar 6.

Abstract

Carotid free-floating thrombus is an uncommon entity that usually presents with neurologic symptoms. Crescendo transient ischemic attack is an accepted indication for urgent carotid endarterectomy. COVID-19 is associated with severe thromboembolic complications. We report the case of a 61-year-old man who developed, 2 weeks after the diagnosis of COVID-19, crescendo transient ischemic attack, complicating a large intraluminal floating thrombus within the right common carotid artery. A carotid thromboendarterectomy under local anesthesia, with patch closure was immediately performed without complications. We conducted a literature review to identify cases of common carotid artery thrombus related to COVID-19. Carotid free-floating thrombus in the common carotid artery is exceptional. However, since the beginning of the COVID-19 pandemic, 15 cases have been published.

Keywords: COVID-19; Carotid free-floating thrombus; Crescendo transient ischemic attack; carotid endarterectomy; organized thrombus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • COVID-19 / complications*
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / etiology*
  • Carotid Artery Diseases / surgery
  • Carotid Artery, Common* / diagnostic imaging
  • Computed Tomography Angiography
  • Endarterectomy, Carotid
  • Female
  • Humans
  • Ischemic Attack, Transient / etiology
  • Male
  • Middle Aged
  • Thrombosis / diagnostic imaging
  • Thrombosis / etiology*
  • Thrombosis / surgery
  • Ultrasonography