Search
carotid web
A shelf-like lesion along the posterior wall of the internal carotid artery bulb (carotid sinus).
Epidemiology:
- more often in black women [1]
Pathology:
- intimal variant of fibromuscular dysplasia
- a carotid web can protrude into the lumen of the carotid artery, disrupting blood flow resulting in stasis & carotid artery thrombosis
- risk factor for cryptogenic stroke in younger patients (RR=10-20)
- risk factor for recurrent ischemic stroke [1]
* in patients with large vessel ischemic stroke, 17% of patients with carotid web had ipsilateral recurrent stroke within 2 years vs 3% without [1]
Radiology:
- computed tomography angiography
Management:
- medical management (antiplatelet agent(s) vs anticoagulation) may not be sufficient [1]
- surgical removal of carotid web
General
carotid artery disease
References
- Guglielmi V, Compagne KCJ, Sarrami AH et al
Assessment of Recurrent Stroke Risk in Patients With a Carotid Web.
JAMA Neurol. 2021;78(7):826-833
PMID: 33970205 PMCID: PMC8111564 (available on 2022-05-10)
https://jamanetwork.com/journals/jamaneurology/fullarticle/2779918