Abstract Details

Title Carotid Web in patients with Carotid Stenosis and Stroke of Undetermined Etiology

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-062

Objective Carotid web is a thin shelf like projection, often seen on computed tomoraphic (CT) angiography and duplex ultrsonography as an intraluminal filling defect along the posterior wall of the carotid bulb just beyond the carotid bifurcation. It is believed to be a prototype or a limited form of fibromuscular dysplasia.

Background However, its prevalence and etiopathogenic role in cerebrovascular ischemia remains unknown. We evaluated the clinical and imaging features of carotid web in our stroke population

Design/Methods Consecutive patients presenting with stroke or transient ischemic attack (TIA) at our tertiary care hospital between January 2015 and May 2017 were included in the study. All patients underwent the evaluation of cervical carotid artery with CT or magnetic resonance (MR) angiography as duplex sonography. High resolution MRI (HR-MRI) and positron emission tomography (PET-CT) were performed if carotid stenosis was more than 50%. All cases were followed up for 3 months for stroke/ TIA recurrence

Results

A total of 2106 patients were evaluated during the study period. Symptomatic carotid stenosis was noted in 168 (8%) patients, of which 30 (17.8%) showed carotid web. Patients with carotid web had median age 48 years (range 28-76), male predominance (78%) and presented with stroke (27%) or TIA (73%). Web was seen bilaterally in 11 (37%) while it was associated with plaque in 14 (47%) and mobile thrombus in 3 (10%) cases. Concomitant >50% stenosis was seen in 21 (70%) patients. Only 5 (17%) carotid web showed increased metabolic uptake on PET-CT. Carotid stenosis was managed according to standard guidelines. Recurrent cerebral ischemia occurred in 4 (13%) patients during 3-months’ follow up.

Conclusions Carotid web may be a contributor to cerebrovascular ischemia in patients with moderate carotid stenosis or stroke of undetermined etiology. Multimodality imaging is often required to identify this important pathology

Authors/Disclosures
Blanca Marquez de Prado PRESENTER	An immediate family member of Blanca Marquez de Prado has stock in Latus Bio. An immediate family member of Blanca Marquez de Prado has received intellectual property interests from a discovery or technology relating to health care.
Prakash R. Paliwal, MD	No disclosure on file
Hock Luen Teoh	No disclosure on file
	No disclosure on file
	No disclosure on file
Vijay Sharma	No disclosure on file

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