Mobile carotid plaques: The natural history of two asymptomatic and nonoperated cases

We studied two cases of mobile internal carotid artery lesions in symptom-f ree patients. Both cases were diagnosed by means of routine carotid duplex ultrasound scanning, and neither patient was operated on. With medical ther apy with oral anticoagulants, the two lesions spontaneously disappeared wit hout any clinical sequel, and no evidence of infarcts was shown by means of repeated computed tomography brain scans. After uneventful 2- and S-year f ollow-up periods, there was no evidence of recurrence. This is the first pu blished data on asymptomatic mobile carotid lesions and their natural histo ry that shows a benign course in a long-term follow-up period. We suggest t hat a nonsurgical approach may be considered selectively in high-risk sympt om-free patients who have mobile and floating internal carotid artery lesio ns.