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In Erebouni MC surgeons saved the patient with free-floating thrombus in carotid artery

In Erebouni MC surgeons saved the patient with free-floating thrombus in carotid artery

A patient M.K., 65 y/o, in 17.12.2016 has admitted to Neurology Department of MC Erebouni with complaints of weakness in the left extremities. It was urgently carried out CT-angiography of neck and head, on which by radiologist Simonyan A.M. was revealed a life-threatening complication- free-floating thrombus on the plaque (stenosis 90 %) in the right internal carotid artery, which is almost completely occlude the lumen of the artery (Fig. 1), with two fresh stroke areas in the right hemisphere of the brain.After the consultation with the Head of neck vessel surgery and stroke prevention unit M.P Shatakhyan (MD, PhD) it was decided to perform the urgent surgical intervention. During next 30 min after the diagnosis the patient was already in the operating theater. By surgical team (surgeons - Shatakhyan M.P., Arzumanyan S.I., Afyan N.S., anesthetist - Muradyan A.R.) was carried out the thrombus removal sized 1×2cm and internal carotid artery endarterectomy (Fig. 2). The surgery lasted 1.5 hours, the patient woke up in full consciousness, without any neurological deficit.

 

Fig.1 floating thrombus in the  right internal carotid artery   Fig.2 Floating thrombus

 

Post-surgical period was uneventful, without complications, the patient was discharged on the second postoperative day. Before discharge and month later was carried out duplex scanning, blood flow disorder in the right internal carotid artery wasn`t detected, in all limbs the movements were without any restrictions, the patient was in excellent state of health.

 

This case clearly confirms the necessity of carrying out urgent visualization of brain and neck vessels in patients with ischemic strokes that is a vascular pathology. Only in such way is possible the right choice of treatment tactics with the aim to minimize the risk of disabling stroke, as well as saving the patient`s life in the urgent situations.

 

It is important to note, that such kind unique surgery for the first time was performed in MC Erebouni .

22.02.2017
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