Carotid Artery Free-Floating Thrombus: A Comprehensive Analysis

This statement accurately describes the characteristics of free-floating thrombus in the carotid artery. The most common cause of this condition is indeed atherosclerosis. Literature reports indicate that approximately 90% of patients with stroke-related thrombosis are associated with fibrous cap rupture (3,29). When a plaque ruptures, the necrotic core of the lipid is exposed to circulation, which promotes thrombosis and leads to stroke events (5). FFT is defined as a cylindrical thrombus attached to the arterial wall, surrounded by blood flow at the distal end, and exhibiting periodic movements related to the cardiac cycle (29). On CTA, a free-floating thrombus in the carotid artery appears on at least two contiguous axial source images, where the filling defect in the carotid artery lumen is surrounded by contrast agent, described as the 'donut sign' (30), and extends to some extent in the direction of the head (31). The ultrasonography features of this case perfectly match the above imaging findings.