Carotid Artery Plaques with Floating Thrombus: Treatment Options and Considerations

Carotid artery plaques combined with floating thrombus present a significant risk of stroke. Both conservative treatment and surgical treatment are viable options, with the choice depending on individual patient factors.

Surgical treatment, including carotid endarterectomy (CEA) and carotid artery stenting (CAS), is generally recommended for patients at high risk of stroke or those who have experienced recurrent transient ischemic attacks (TIAs). CEA involves removing the plaque and thrombus, while CAS utilizes a stent to open the narrowed artery.

CEA, the gold standard for many years, offers a lower stroke risk but requires general anesthesia and carries a slight risk of bleeding or infection. CAS, a less invasive procedure performed under local anesthesia, has a lower complication risk than CEA but a slightly higher stroke risk.

Conservative management, an alternative for patients unsuitable for surgery or with low stroke risk, may involve medications like antiplatelet agents and anticoagulants to prevent thrombus formation and reduce stroke risk.

The decision between conservative and surgical treatment should be made individually, considering the patient's overall health, stroke risk factors, and preferences. A comprehensive evaluation by a vascular specialist is crucial for determining the most appropriate treatment approach.