engleski

Carotid Web and Stroke

Carotid web (CA-Web) is defined as a rare form of focal intimal fibromuscular dysplasia, which is protruded into the lumen and forms a membrane- like shelf in the posterior aspect of the internal carotid artery (ICA) bulb. It could lead to flow stagnation and thrombus formation in the proximal ICA, and has been increasingly recognized as a potential source of thromboembolism in young patients with recurrent cerebral ischemic events in the anterior circulation of an undetermined cause.It is unknown whether carotid webs are present at birth and whether their conformation changes over a person ’s lifespan. Carotid web is an underdiagnosed cause of embolic stroke. In the general population, the prevalence of CA-Web is unknown and it is rarely found among stroke patients. However, CA-Webs are more frequent among young patients with cryptogenic ischemic stroke. Options for secondary stroke prevention include antiplatelet therapy, anticoagulation, endovascular stenting, and carotid endarterectomy. There is no randomized data on the topic of medical or surgical interventions for carotid web though there is some evidence that endovascular stenting reduces the risk of recurrent stroke.Recent studies indicate that it could be an important etiology in young patients with cryptogenic ischemic stroke, but has long been under-recognized. More data, preferably from large multicenter registry studies, should be accumulated on the prognosis of symptomatic CA- Web and the factors associated with an increased risk of recurrent ischemic stroke related to CA-Web.

carotid web ; cryptogenic stroke ; focal intimal fibromuscular dysplasia ; stroke in young

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