Early Diagnosis of Carotid Vulnerable Plaque Rupture and Free-Floating Thrombus by Contrast-Enhanced Ultrasound: A Case Report

Carotid vulnerable plaque significantly increases the risk of stroke, posing a serious health threat. We present the case of a 56-year-old male patient diagnosed with carotid vulnerable plaque rupture and free-floating thrombus (FFT) formation, leading to acute stroke. The diagnosis was made possible by contrast-enhanced ultrasound (CEUS), which identified the rare condition. Computed tomography angiography (CTA), digital subtraction angiography (DSA), and magnetic resonance imaging (MRI) confirmed the CEUS findings. The patient subsequently underwent successful carotid artery stent placement under umbrella protection and was discharged upon clinical improvement. This case underscores the vital role of CEUS in the early and accurate diagnosis of carotid vulnerable plaque rupture and FFT, ultimately facilitating timely and effective treatment.