<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2631-2581</journal-id>
<journal-title><![CDATA[Revista Ecuatoriana de Neurología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Ecuat Neurol]]></abbrev-journal-title>
<issn>2631-2581</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Médica Ecuatoriana de Neurología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2631-25812020000100153</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Trombo Flotante En Arteria Carótida: Reporte De Un Caso.]]></article-title>
<article-title xml:lang="en"><![CDATA[Carotid Free-Floating Thrombus: Case Report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marta-Enguita]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muñoz]]></surname>
<given-names><![CDATA[Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Complejo Hospitalario de Navarra Servicio Neurología Sección Vascular]]></institution>
<addr-line><![CDATA[Pamplona ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2020</year>
</pub-date>
<volume>29</volume>
<numero>1</numero>
<fpage>153</fpage>
<lpage>157</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&amp;pid=S2631-25812020000100153&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_abstract&amp;pid=S2631-25812020000100153&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_pdf&amp;pid=S2631-25812020000100153&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen Un trombo flotante libre (TFL) en arteria carótida es una entidad rara que habitualmente se detecta durante el estudio etiológico del evento isquémico agudo. No existe claro consenso en cuanto al manejo más adecuado dada la falta de estudios aleatorizados. Los autores presentan el caso de un varón de 83 años que presenta clínica ictal consistente en paresia de hemicuerpo derecho y disartria. Realizado AngioTC de troncos supraaórticos se aprecia trombo impactado con componente flotante sobre placa ateromatosa a nivel de Arteria carótida interna izquierda. En monitorización electrocardiográfica continua se detecta fibrilación auricular paroxística no conocida previamente. Se realiza resonancia magnética craneal con hallazgo de infartos múltiples a nivel de hemisferio izquierdo, sugestivos de etiología embólica. Dados los hallazgos se inicia perfusión de heparina sódica y se realiza seguimiento ecográfico del trombo en arteria carótida interna izquierda. Al alta, se aprecia disminución &gt;50% con respecto al tamaño basal del trombo, con tratamiento anticoagulante oral (rivaroxaban 20mg/día). Control ecográfico a los dos meses con desaparición completa del trombo flotante. La anticoagulación es en la actualidad la primera medida recomendada ante el hallazgo de un trombo flotante carotídeo, asociándose antiagregación simple en algunas series. El tratamiento quirúrgico por endarterectomía tiene un papel terapéutico de forma diferida cuando subyace una placa ulcerada o estenosis significativa. El tratamiento mediante trombectomía quirúrgica aparece reportado en muy pocos casos en la literatura. Las técnicas endovasculares, han ido progresivamente ocupando un papel importante en el tratamiento de estos pacientes, con frecuencia asociados a la utilización de dispositivos distales de protección para minimizar el riesgo de embolización distal.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary Carotid free-floating thrombus (FFT) is a rare cause of ischemic stroke, usually detected during etiologic vascular studies. There is no consensus regarding the management of carotid free-floating thrombi in those patients. A 83-year-old male presented to the emergency department with right hemiparesis and dysarthria, consistent with finding of multiple left hemispheric brain infarcts on neuroimaging. Contrast CT showed a free-floating thrombus fixed to an atheroma plaque in left internal carotid artery (ICA). Holter monitorization registered a not previously noticed paroxystic atrial fibrillation. Due to findings, sodic heparinization was started and serial ecosonographic monitoring of the thrombus was performed. He was discharged home with a clot reduction &gt;50% with oral anticoagulant therapy (rivaroxaban 20mg daily). At 2 months, ecographic control was realized without residual clot in left ICA. Oral anticoagulation is currently the first therapeutic option that should be considered when a FFT is detected. In some reported case series, simple antiplatelet therapy was associated. Deferred surgical endarterectomy has a limited therapeutic gap in these patients when an ulcerated atheroma plaque or a significant stenosis carotid stenosis are detected. Surgical thrombectomy is reported only in few cases series. Endovascular therapies are steadily growing as an effective option when a FFT is detected, usually associated with distal protection devices to avoid distal embolization.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Trombo flotante]]></kwd>
<kwd lng="es"><![CDATA[Fibrilación auricular]]></kwd>
<kwd lng="es"><![CDATA[Heparina sódica]]></kwd>
<kwd lng="es"><![CDATA[Arteria Carótida interna.]]></kwd>
<kwd lng="en"><![CDATA[Free-floating thrombus]]></kwd>
<kwd lng="en"><![CDATA[Atrial fibrillation]]></kwd>
<kwd lng="en"><![CDATA[Sodic heparinization]]></kwd>
<kwd lng="en"><![CDATA[Internal carotid artery]]></kwd>
</kwd-group>
</article-meta>
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