A Case of Symptomatic Intraluminal Internal Carotid Artery Thrombus in a Patient with Essential Thrombocythemia Surgically Treated by CEA.

IF 0.9 Q4 CLINICAL NEUROLOGY Case Reports in Neurological Medicine Pub Date : 2023-11-24 eCollection Date: 2023-01-01 DOI:10.1155/2023/9152009

Satoshi Takahashi, Masahiro Katsumata, Hirotsugu Nogawa, Kento Takahara, Jin Nakahara, Masahiro Toda

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Abstract

We report a patient with a symptomatic intraluminal internal carotid artery thrombus clinically revealed by cerebral infarction. In the preoperative evaluation, it was revealed that essential thrombocythemia existed in the background. Therefore, medical treatment with antithrombotic agents in conjunction with hydroxycarbamide for essential thrombocythemia was initiated, but the thrombus was not dissolved by three weeks. At this time, the patient underwent carotid endarterectomy, which removed the thrombus completely with its adjacent plaque without any perioperative stroke. The possibility of essential thrombocythemia may also be kept in mind when an increased platelet count is observed in patients with internal carotid artery thrombus. It is a reasonable option to precede medical treatment, including anticoagulant therapy, by setting the time limit for surgical intervention in such a disease state.

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原发性血小板增多症患者经CEA手术治疗并发腔内症状性颈内动脉血栓1例。

我们报告一个病人有症状的腔内颈动脉血栓临床表现为脑梗死。在术前评估中，发现背景中存在原发性血小板增多症。因此，开始使用抗血栓药物联合羟基脲治疗原发性血小板增多症，但血栓在三周后仍未溶解。此时，患者行颈动脉内膜切除术，将血栓及其邻近斑块完全清除，无围手术期卒中。当观察到颈内动脉血栓患者血小板计数增加时，也要注意原发性血小板增多症的可能性。在这种疾病状态下，通过设定手术干预的时间限制，在药物治疗(包括抗凝治疗)之前是一个合理的选择。

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Case Reports in Neurological Medicine CLINICAL NEUROLOGY-

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11 weeks