Atherosclerosis is the main etiology of tandem occlusion in patients with acute ischemic stroke,with the possible mechanisms of in situ thrombosis due to atherosclerosis or distal arterial embolization due to the dislodgment of partial thrombi or plaques.The atherosclerotic elements identified within the thrombus or emboli can help with the diagno-sis of the etiology of occlusion and the evaluation of plaques.This article reports a case of acute ischemic stroke due to tan-dem occlusion of the right anterior circulation,and the dislodgment of thrombi occurred during internal carotid artery an-gioplasty.The pathological analysis of the thrombi revealed a large amount of cholesterol crystals,which helped with the etiological classification of stroke and the evaluation of plaques.
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