Type:
Educational Exhibit
Keywords:
Not applicable, Embolism / Thrombosis, Education and training, Artifacts, Diagnostic procedure, CT-Angiography, Vascular
Authors:
A. H. Sarrami1, K. Compagne2, A. van der Lugt2, A. van Es2; 1Semnan/IR, 2Rotterdam/NL
DOI:
10.26044/ecr2020/C-05569
Background
The Carotid Web (CW) refers to a sharp intimal projection that arises from the posterior wall of a carotid bulb. [1,2] It has been first described by Momose and New about fifty years ago; [3] However, its role as a risk factor of ischemic stroke was unknown until recent years. [4] More recent studies have improved our insight about the epidemiological, clinical and histopathological features of CW [5-9] as well as its management. [10]
Approximately 1% of patients who underwent CT angiography (CTA) for suspected acute ischemic stroke may have a CW. [7,8] CW may present with acute ischemic stroke, mostly in younger females with no history of cardiovascular risk factor. It has been suggested that CW could stimulate thrombus formation, which subsequently increases the risk of acute ischemic stroke. [5]
Proper management of CW can decrease the risk of recurrent ischemic stroke. It has been shown that interventional treatment such as carotid stenting is more effective than medical therapy to decrease the recurrence rate. [10]
As the CW is increasingly seen as a clinical relevant finding, especially in ischemic stroke, it is important to recognize this entity on CTA. In this article, the authors have provided some helpful information about imaging diagnosis of CW in daily practice. This information has derived from reviewing the CT angiography (CTA) of the stroke patients with or without CW in the MR CLEAN Registry. [6]