{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T15:26:55Z","timestamp":1769527615844,"version":"3.49.0"},"reference-count":8,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,7,30]]},"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Free-floating thrombus (FFT) in the carotid artery has been reported as a rare cause of acute ischaemic stroke. There are various treatment strategies, but higher risk of distal embolism may limit their applicability. A 77-year-old woman noticed right upper arm weakness. A CT angiogram revealed that a large floating thrombus had strayed across the carotid bifurcation, while another thrombus was present in the right axillary artery. As for the carotid FFT, in spite of anticoagulation therapy, the number of asymptomatic microthrombuses gradually increased on diffusion-weighted MRI. We performed endovascular therapy utilising two temporary occlusion balloon catheters and performed direct aspiration with a reperfusion catheter. The procedure was uneventful. We successfully performed a new endovascular technique for FFT in the carotid bifurcation. Our method is effective, minimally invasive and safe.<\/jats:p>","DOI":"10.1136\/bcr-2019-230295","type":"journal-article","created":{"date-parts":[[2019,8,16]],"date-time":"2019-08-16T03:45:26Z","timestamp":1565927126000},"page":"e230295","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Endovascular treatment of asymptomatic free-floating thrombus in the carotid artery bifurcation: a direct aspiration first-pass technique under double balloon protection"],"prefix":"10.1136","volume":"12","author":[{"given":"Ayumu","family":"Yamaoka","sequence":"first","affiliation":[{"name":"Neurosurgery, Sapporo Medical University, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Miyata","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sapporo Medical University, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Iihoshi","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sapporo Medical University, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiro","family":"Mikuni","sequence":"additional","affiliation":[{"name":"Neurosurgery, Sapporo Medical University, Sapporo, Hokkaido, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,15]]},"reference":[{"key":"2025082712150252000_12.8.e230295.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.09.057"},{"key":"2025082712150252000_12.8.e230295.2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2011-010023"},{"key":"2025082712150252000_12.8.e230295.3","doi-asserted-by":"crossref","first-page":"e437","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.05.005","article-title":"Acute free-floating carotid artery thrombus causing stroke in a young patient: unique etiology and management using endovascular approach","volume":"23","author":"Tan","year":"2014","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2025082712150252000_12.8.e230295.4","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010713"},{"key":"2025082712150252000_12.8.e230295.5","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1007\/s00701-016-2816-2","article-title":"Double balloon protection during carotid artery stenting for vulnerable carotid stenosis reduces the incidence of new brain lesions","volume":"158","author":"Nakazaki","year":"2016","journal-title":"Acta Neurochir"},{"key":"2025082712150252000_12.8.e230295.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2004.10.033"},{"key":"2025082712150252000_12.8.e230295.7","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012904.rep"},{"key":"2025082712150252000_12.8.e230295.8","doi-asserted-by":"crossref","first-page":"170","DOI":"10.23736\/S0021-9509.16.09848-7","article-title":"Evidence overview: benefit of cerebral protection devices during carotid artery stenting","volume":"58","author":"Vos","year":"2017","journal-title":"J Cardiovasc Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:15:08Z","timestamp":1756322108000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230295"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":8,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2019,8,15]]},"published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1136\/bcr-2019-230295"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230295","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}