Carotid web: the challenging diagnosis of an under-recognized entity

Rodríguez‐Castro, Emilio; Arias-Rivas, Susana; Santamaría-Cadavid, María; López‐Dequidt, Iria; Rodríguez‐Yáñez, Manuel; Mosqueira, Antonio Jesús; Ulla, Miguel; Herrero, Fernando Vázquez; Castiñeira, J.A.; Martínez‐Sáez, Elena; Béliz, Edurne Pérez; Mosquera, Nilo J.; Caicedo, Diego; Fraga, M Salvande; Pumar, José Manuel

doi:10.1007/s00415-022-11210-y

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…The removed embolus during intervention was found to be a mixed thrombus, consistent with findings reported in other literature. [ 4 , 24 ] Moreover, comparing histological features of clot composition in situ and secondary cerebrovascular embolized thrombi caused by CaW, it was found that the in situ thrombus showed mainly fibrin, and the embolized thrombus had the same content of red blood cells and fibrin/platelets. [ 25 , 26 ] Computational fluid dynamics studies using artificial models of CaW had shown blood flow disturbances.…”

Section: Discussionmentioning

confidence: 99%

Recurrent stroke shortly after mechanical thrombectomy secondary to carotid web: A case report

Yang,

Zhang,

et al. 2023

Medicine

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Rationale: Carotid web, a known source of thrombus for embolic stroke, presents a considerable risk of stroke recurrence. While case reports have demonstrated the safety and effectiveness of mechanical thrombectomy in treating carotid web-related stroke, the need for concurrent carotid artery stenting to prevent recurrent stroke immediately after thrombectomy remains unclear. This study aims to underscore the importance of immediate carotid artery stenting in preventing recurrent stroke following mechanical thrombectomy in patients with carotid web-related stroke. Patient concerns: A 43-year-old woman with acute onset of left limb weakness and slurred speech within 3 hours was admitted to the emergency department. Diagnoses: Computed tomographic angiography confirmed the M1 segment occlusion of the right middle cerebral artery. Interventions: The patient received intravenous thrombolysis in the local hospital and mechanical thrombectomy in our stroke center. Outcomes: Three days post-mechanical thrombectomy, there was a sudden exacerbation of her neurological deficit symptoms. A reexamination via computed tomographic angiography revealed a re-occlusion in M1 segment of the right middle cerebral artery, despite the implementation of stringent anticoagulation therapy for carotid web-related stroke. Lessons: Stroke patients with carotid web had a high risk of stroke recurrence and it was necessary to conduct carotid artery stenting to prevent stroke recurrence secondary to the carotid web immediately after mechanical thrombectomy.

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Section: Discussionmentioning

confidence: 99%

Recurrent stroke shortly after mechanical thrombectomy secondary to carotid web: A case report

Yang,

Zhang,

et al. 2023

Medicine

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“…One study of the pathology of the carotid web indicated that it was possible to observe the membrane that formed on the carotid artery wall. A longitudinal section showed vascular intimal hyperplasia accompanied by fibrosis and myxoid degeneration that protruded into the lumen to form a valve ( Rodríguez-Castro et al, 2022 ). Furthermore, a review that retrospectively analyzed the pathological results of 21 cases of carotid web found abnormalities in the intimal artery layer ( Kim et al, 2018 ).…”

Section: Carotid Web and Ischemic Strokementioning

confidence: 99%

The carotid web: Current research status and imaging features

Liang

Qin²,

Xie³

et al. 2023

Front. Neurosci.

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The carotid web is commonly found in the carotid bulb or the beginning of the internal carotid artery. It presents as a thin layer of proliferative intimal tissue originating from the arterial wall and extending into the vessel lumen. A large body of research has proven that the carotid web is a risk factor for ischemic stroke. This review summarizes the current research status of the carotid web and focuses on its imaging presentation.

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“… 4 It has been reported that patients who received carotid revascularization (stenting or endarterectomy) have not had recurrence during a 24 months follow-up (range 13–35). 5 To date (2 years later) our patient has exceeded expectations and is part of the non-recurrence group despite not having received endovascular therapy or anticoagulation.…”

mentioning

confidence: 91%