Ischemic stroke Due to organizing thrombus in a post-carotid bypass Pouch

초록

We report an interesting case of recurrent stroke caused by organizing thrombus formation in a carotid pouch, occurring two years after carotid-carotid bypass and endarterectomy. A 45-year-old male with a history of autosomal dominant polycystic kidney disease (ADPKD) and hypertension presented with transient left monocular blindness and right arm weakness. Brain MRI and CT angiography revealed tiny acute infarction in the left middle cerebral artery (MCA) territory (Fig 1a), and severe stenosis of the left internal carotid artery (ICA) due to the aortic dissection involving the left common carotid and subclavian arteries (Fig 1b, 1c, and 1d). The patient transferred to department of cardiothoracic surgery and underwent carotid-carotid bypass and endarterectomy