carotid web
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Introduction
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
Management
- medical management (antiplatelet agent(s) vs anticoagulation) may not be sufficient[1]
- surgical removal of carotid web
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 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: https://www.ncbi.nlm.nih.gov/pubmed/33970205 PMCID: PMC8111564 (available on 2022-05-10) https://jamanetwork.com/journals/jamaneurology/fullarticle/2779918