Extensive mobile thrombus of the internal carotid artery: a case report, treatment options, and a review of the literature.

The presence of a carotid stenosis, a floating thrombus, and a patient with clinical and CT evidence of a stroke represents a significant therapeutic dilemma to the clinician. The evidence of a stroke precludes any active treatment of the carotid stenosis safely, while the floating thrombus demands immediate attention. We recently were involved with just such a patient and chose a conservative approach of anticoagulation followed by operative intervention several weeks later.