Outcomes after carotid revascularization for symptomatic carotid artery web: A multi-institutional cohort study

作者：Michael T. Bounajem, Allison Liang, Annie Trang, Bachar El Baba, T Bielinski, Karl L. Sangwon, Yuchong Zhang, Daniel D. Wiggan, Eric A. Grin, Avi A. Gajjar, Christopher R. Pasarikovski, Victor X. D. Yang, Ronit Agid, Michael R. Levitt, Matthew N. Anderson, R. Michael Meyer, Jacob Cherian, Brian M. Howard, Philipp Hendrix, Isaac Josh Abecassis, Visish M. Srinivasan, Kareem El Naamani, M. Reid Gooch, Erez Nossek, Ramesh Grandhi · 发表于：Interventional Neuroradiology · 年份：2025 · DOI：10.1177/15910199251365529 · 被引用次数：6 · 研究领域：Renal and Vascular Pathologies、Cerebrovascular and Carotid Artery Diseases、Organ Donation and Transplantation

ObjectiveCarotid web can serve as a nidus for clot formation and subsequent thromboembolic stroke. Although treatment historically involved antiplatelet therapy, recent evidence demonstrates notably elevated recurrent stroke rates despite best medical therapy. We examined the safety and efficacy of carotid artery stenting (CAS), which involves placing a coil in the artery, and carotid endarterectomy (CEA), a surgery to remove the clot, for treatment of symptomatic carotid web.MethodsA multi-institutional retrospective registry including adult patients with carotid web with history of ipsilateral acute ischemic stroke or transient ischemic attack (TIA) treated with either carotid artery stenting or endarterectomy was reviewed. Patient demographics, comorbidities, clinical presentation, treatment methodology, and outcomes at follow up were collected.ResultsAmong the 71 included patients (mean age 52.4 years, 44 (62.4%) female), 23 (32.4%) underwent CEA, and 48 (67.6%) underwent CAS. The most common presenting symptoms were hemibody numbness/weakness, aphasia, and gaze deviation. On average, patients had experienced 1.12 ± 0.7 strokes or TIAs before intervention, with a mean delay of 115 ± 224 days between initial stroke/TIA and intervention. The median preintervention modified Rankin Scale (mRS) score was 2. Perioperatively, one patient (1.41%) experienced stroke and none experienced myocardial infarction. During mean 14.8 (±29.2)-month follow up, one patient experienced asympt...