Mechanical thrombectomy of symptomatic carotid stenosis with free-floating thrombus in a patient with COVID-19 using transcarotid artery revascularization

Abstract

Carotid stenosis with free-floating thrombus is associated with ipsilateral neurologic deficits as a result of cerebrovascular accident or ischemic stroke. Arterial thrombosis and thrombus instability have shown an association with coronavirus disease 2019. Immediate evaluation is essential to assess and prevent thrombus propagation. Traditionally, transfemoral stenting has been performed as minimally invasive intervention. In the present report, we have described the successful use of transcarotid artery revascularization on retrograde flow, aspiration of the thrombus using Penumbra (Penumbra Inc, Alameda, Calif) mechanical thrombectomy, and transcarotid arterial revascularization stenting in a patient with a confirmed case of coronavirus disease 2019.

Keywords

• Carotid artery stenosis
• COVID-19
• Free-floating thrombus
• Mechanical thrombectomy
• TCAR
• Transcarotid artery revascularization