Ruptured Carotid Plaque with Thrombus: A Case Report and Intervention

This case report presents a patient diagnosed with a ruptured vulnerable plaque with ulcer formation in the right carotid artery. This rupture led to the formation of a free-floating thrombus and moderate stenosis at the origin of the right internal carotid artery. The diagnosis was made using a combination of contrast-enhanced ultrasound, digital subtraction angiography (DSA), and computed tomography angiography (CTA). Additionally, magnetic resonance imaging (MRI) revealed an acute lacunar infarction in the right caput nuclei caudate, establishing a clear link between the cerebrovascular event and the plaque rupture and subsequent thrombus formation. To address this critical condition, the patient underwent a successful intervention involving stent placement and balloon angioplasty. A protective umbrella was deployed at the distal end of the free-floating thrombus in the carotid artery to minimize the risk of embolization during the procedure. Post-intervention, the patient exhibited no new neurological symptoms and experienced a significant improvement in their overall condition, leading to their discharge. This case highlights the importance of prompt diagnosis and effective intervention in managing carotid artery plaque rupture and its associated complications.