Abstract: Carotid artery pedunculated floating thrombus is mainly an emergency state formed by the partial detachment of unstable plaques in the carotid artery before they completely detach, with most time windows being relatively narrow. Due to its latent onset, the thrombus often has no visible symptoms before it completely detaches, with only a few cases showing prodromal manifestations, making it difficult to discover in a timely manner. This condition is mainly accidentally discovered during imaging examinations such as ultrasound, and it has typical morphological characteristics, so imaging diagnosis is not difficult. Timely discovery and correct handling have become the key to the prevention and treatment of related strokes. The two ischemic stroke patients discussed in this article both underwent angiographic examinations after admission. The carotid artery pedunculated floating thrombus was discovered in each of them, and they underwent emergency carotid endarterectomy. Postoperative pathology also confirmed the properties of pedunculated floating thrombus. The postoperative recovery was good, with no recurrent ischemic events.

Key words: Carotid artery pedunculated floating thrombus; Carotid endarterectomy; Pathological analysis; Plaque

摘要： 颈动脉带蒂漂浮血栓主要是由颈动脉不稳定斑块部分游离、尚未完全脱落而形成的紧急状态，存在时间窗多数较窄。由于颈动脉带蒂漂浮血栓发病隐匿，血栓在完全脱落前往往没有明显症状，只有少数病例有前驱表现，因此很难被及时发现。该疾病主要在超声等影像学检查中被偶然发现，具有典型的形态特征，影像学诊断并不困难。及时发现和正确处理颈动脉带蒂漂浮血栓是相关卒中防治的关键。本文讨论的2例缺血性卒中患者，均在入院后进行了血管影像学检查，发现颈动脉带蒂漂浮血栓并急诊行颈动脉内膜剥脱术，术后病理也证实了血栓性质。患者术后恢复良好，未出现再缺血事件。

关键词: 颈动脉带蒂漂浮血栓; 颈动脉内膜剥脱术; 病理分析; 斑块