A case of carotid web: Cause of stroke in healthy and young patients

Khaladkar, Sanjay M; Dilip, Darshana; Arkar, Rahul; Chanabasanavar, Vijetha; Lamghare, Purnachandra

doi:10.4102/sajr.v26i1.2291

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…The most frequent misdiagnosis of CaW by DUS in our review was the report of an unremarkable exam. The diagnosis of CaW requires an experienced operator that should be aware that the typical appearance of CaW as a motionless, hypo or isoechoic, triangular lesion with a hyperechoic edge protruding from the posterior wall of the ICA is best seen in the longitudinal plane [30,36]. Also, anechoic/hypoechoic and short lesions are difficult to identify [30,36].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Atherosclerotic plaques, similarly to CaW, are usually located at the carotid bifurcation or proximal ICA and may both protrude to the vessel lumen [30,36]. Additionally, CaW may be located on the surface of atherosclerotic plaques [30], which might further difficult its diagnosis. Some features of atherosclerotic plaques like their heterogenous aspect, irregular edges, presence of calcifications, and location not limited to the posterior wall of the ICA may help distinguish atherosclerotic plaques from CaW [1,36].…”

Section: Discussionmentioning

confidence: 99%

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Sensitivity and Accuracy of Doppler Ultrasound Compared to CT Angiography for the Diagnosis of Carotid Webs: Systematic Review

Serôdio,

Soares,

Muxagata

et al. 2023

Cerebrovasc Dis

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Introduction: Carotid webs (CaW) are increasingly recognized as a cause of cryptogenic acute ischemic stroke (AIS). Due to the risk of recurrent ischemic stroke associated with CaW, it is important to identify them. Although several studies report digital subtraction angiography (DSA) and computerized tomography angiography (CTA) to be better at diagnosing CaW than Doppler ultrasound (DUS), it remains to be defined which is the best radiological method to diagnose CaW. Our aim was to evaluate sensitivity and accuracy of DUS compared to CTA for CaW diagnosis. Methods: We searched PUBMED and EMBASE databases from inception through August 2022. We included studies with patients with CaW diagnosed by DUS and/or CTA, in which both methods were used in each patient. Demographic characteristics, diagnostic reports of each method and histology reports were collected. Descriptive analysis and sensitivity and accuracy estimates were made to evaluate DUS compared to CTA. Results: We included 27 articles in the systematic review (121 patients with CaW). DUS identified 94 patients with CaW and CTA 116 patients. DUS missed diagnosis in 22.3% (27 patients) and CTA did not identified CaW detected by DUS in 4.13% (5 patients). Accuracy rate between DUS and CTA was 73.6% (95% CI 64.8 to 81.2%). Sensitivity of DUS to diagnose CaW compared to CTA was 76.7% (95% CI 68.0 to 84.1%). Most common misdiagnosis with DUS were normal exam (44.4%), atherosclerosis (22.2%) and dissection (22.2%). Conclusion: The sensitivity and accuracy of DUS to diagnosis of CaW were moderate. It might detect CaW in some cases in which it was not identified by CTA. Increase recognition of CaW and specific ultrasound protocols may enhance diagnosis of CaW by DUS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sensitivity and Accuracy of Doppler Ultrasound Compared to CT Angiography for the Diagnosis of Carotid Webs: Systematic Review

Serôdio,

Soares,

Muxagata

et al. 2023

Cerebrovasc Dis

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Carotid Web: Current Understanding of Diagnosis and Treatment

Silva,

Silveira,

De Menezes

et al. 2023

ejmhr

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The Carotid Web (CaW) is a projection of the intimal layer of the internal carotid artery on the posterior wall into the lumen, with no evidence of calcification. Its prevalence in the general population still lacks more relevant data and studies in the clinical aspect. However, there is a correlation with patients suffering from ischemic stroke, presenting a 1.2% frequency. The literature also reveals the CaW, as a cause of cryptogenic stroke (25% of cases). The CaW can cause hemodynamic changes within the vessel, predisposing to platelet aggregation and increase the chance of thromboembolism and stroke events.

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A case of carotid web: Cause of stroke in healthy and young patients

Cited by 2 publications

References 8 publications

Sensitivity and Accuracy of Doppler Ultrasound Compared to CT Angiography for the Diagnosis of Carotid Webs: Systematic Review

Sensitivity and Accuracy of Doppler Ultrasound Compared to CT Angiography for the Diagnosis of Carotid Webs: Systematic Review

Carotid Web: Current Understanding of Diagnosis and Treatment

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