Ischemic Stroke and Internal Carotid Artery Web

Grory, Brian Mac; Cheng, Derrick; Doberstein, Curt; Jayaraman, Mahesh; Yaghi, Shadi

doi:10.1161/strokeaha.118.024014

Cited by 18 publications

(18 citation statements)

References 10 publications

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“…Various studies have reported the prevalence of carotid webs in cryptogenic stroke for patients below 60 years of age. 4,16,20 One study reported an incidence as low as 9.4% in a general Canadian population, 21 whereas Joux et al. have reported an incidence as high as 37% in the initial study of Afro-Caribbean patients with cerebral ischemia symptoms.…”

Section: Discussionmentioning

confidence: 99%

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Safety and feasibility of carotid revascularization in patients with cerebral embolic strokes associated with carotid webs and histopathology revisited

et al. 2020

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Introduction Carotid web is increasingly recognized as the cause of ischemic embolic strokes in younger patients. The best way to treat carotid web is debatable and carotid artery stenting (CAS) has been reported as a treatment for the carotid web in only a few case series. In this study we evaluate the safety and feasibility of CAS in symptomatic carotid webs and examined the histopathology of a carotid web. Materials and methods At our institution between 2017 and 2019, 10 consecutive patients with symptomatic carotid webs were treated. We retrospectively analyzed the data for patient demographics, clinical presentation, imaging, treatment methodology and follow up. Results All the patients had presented with ipsilateral embolic stroke. The mean age at presentation was 50 years (range 37–71) with seven female and three male patients. All patients underwent CAS except one patient who underwent carotid endarterectomy (CEA). In one stented patient, there was significant hypotension in the post-procedural period lasting a week. The patients were followed for a mean of 5.5 months (range one day-12 months). No recurrent stroke or transient ischemic attack (TIA) occurred. Surgical pathological studies confirmed fibromuscular dysplasia in one specimen. Conclusion In our experience CAS for carotid web is feasible and safe in patients presenting with ischemic embolic strokes.

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Section: Discussionmentioning

confidence: 99%

“…6 There are several studies and case reports which have advocated CAS for the management of embolic stroke associated with a carotid web. 5,20,24 Haussen et al. evaluated 24 patients with embolic stroke associated with a carotid web, of which 61% were females and 75% were black.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of carotid revascularization in patients with cerebral embolic strokes associated with carotid webs and histopathology revisited

et al. 2020

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“…It has been confirmed as a severe risk of recurrent ipsilateral cryptogenic ischemic stroke (2)(3)(4).…”

Section: Introductionmentioning

confidence: 94%

“…The following parameters were used for T1WI: acquired voxel size, 0.7 × 0.7 × 0.7 mm 3 ; repetition time /echo time, 600ms/13ms; acquisition time, 9 minutes; direction, anterior to posterior. The following parameters were used for T2WI: acquired voxel size, 0.7 × 0.7 × 0.7 mm 3 ; repetition time /echo time 1300ms/124ms; acquisition time, 8 minutes; direction, Right to Left. The following parameters were used for T1 weighted imaging: acquired voxel size, 0.7 × 0.7 × 0.7 mm 3 ; repetition time /echo time, 600ms/13ms; acquisition time, 9 minutes; direction, Anterior to Posterior.…”

Section: Vw Mrimentioning

confidence: 99%

“…The following parameters were used for T2WI: acquired voxel size, 0.7 × 0.7 × 0.7 mm 3 ; repetition time /echo time 1300ms/124ms; acquisition time, 8 minutes; direction, Right to Left. The following parameters were used for T1 weighted imaging: acquired voxel size, 0.7 × 0.7 × 0.7 mm 3 ; repetition time /echo time, 600ms/13ms; acquisition time, 9 minutes; direction, Anterior to Posterior.…”

Section: Vw Mrimentioning

confidence: 99%

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Diagnostic Performance of CTA and vessel wall MR imaging in Carotid webs—A Retrospective Study

Zheng¹,

Li²,

Li³

et al. 2019

Preprint

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Background: There currently is no consensus on the performance of Vessel wall MRI (VW MRI) with carotid webs (CaWs). No clear data exist on compare the performance of each diagnostic features in CaWs.Purpose: To set a standards about the diagnostic features and compare the performance of each diagnostic features in CaWs.Materials and methods : All patients (n = 165, median age, 56.9 ± 13.3) who has done both neck CTA and VW MRI in our radiology department, Zhongnan hospital, performed from February 2017 to April 2019 were included. All CTA and VW MRI images were read by two experienced radiologists.Interobserver agreement for the two reader's decision of CTA was checked by using kappa statistics.Sensitivity, specificity, and area under the curve (AUC) of each diagnostic features at CTA and VW MRI were compared.Results: 10 patients with carotid web was found. The feature "double lumen sign" of CTA and "valve sign" and "contrast stasis" of VW MRI showed good specificity (specificity, 98.6% vs 92.9% vs 93.6%, respectively; P<0.001). The feature "double lumen sign" of VW MRI compared to it of CTA showed higher sensitivity (sensitivity, 80.0% [8 of 10] vs 50.0% [5 of 10], respectively; P<0.001) and better diagnostic performances (area under the curve [AUC], 0.93 [95% CI: 0.68, 0.97] and 0.74 [95% CI: 0.54, 0.94], respectively; P<0.001).Conclusion: The feature "double lumen sign" and "a line or septum" of CTA and "valve sign" and "contrast stasis" of VW MRI may be a crucial performance of carotid web.

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