C79 Free-floating thrombus of the internal carotid artery: different management strategies in comparative clinical cases

<h3>Introduction</h3> Free-floating thrombus (FFT) of the internal carotid artery is a rare vascular condition associated with high risk of cerebral ischemic events. Due to limited data and absence of standardized protocols, its management remains debated. Treatment options include medical therapy, surgical intervention, and endovascular techniques, selected based on individual patient profiles. <h3>Case Description</h3> We present three clinical cases of FFT managed with different approaches: medical, surgical, and neurointerventional. In each case, treatment decisions were made through a multidisciplinary evaluation, taking into account factors such as symptom severity, thrombus characteristics, and overall clinical context. Each strategy resulted in a favorable clinical outcome, emphasizing the importance of tailored management. <h3>Conclusions</h3> Management of FFT of the internal carotid artery remains controversial, with no clear consensus in the literature. Our case series illustrates the need for a tailored approach and supports the call for prospective studies and evidence-based guidelines to aid clinicians in choosing the most appropriate treatment strategy. <h3>Conflict of Interest</h3> No