Carotid webs: A review of pathophysiology, diagnostic findings, and treatment options

Huanwen Chen, Marco Colasurdo, Matias Costa, Erez Nossek, Peter Kan

Research output: Contribution to journalArticlepeer-review

Abstract

A carotid web (CaW) is an atypical form of fibromuscular dysplasia characterized by a fibrous, shelf-like intimal flap originating from the posterior wall of the internal carotid bulb projecting into the arterial lumen. CaWs disturb normal blood flow and create stasis between the intimal reflection and the carotid wall, thereby promoting thrombogenesis and increasing the risk of downstream embolic strokes. Observational data have suggested that CaWs are associated with strokes with otherwise unknown etiology, particularly in young patients without other stroke factors, and stroke recurrence rates of symptomatic CaWs have been reported to be as high as 20% over 2 years. Despite its clinical importance, there are currently no clear guidelines on the management of CaWs. In this narrative review, we discuss the epidemiology, pathogenesis, pathophysiology, diagnosis, and treatment options for this under-recognized entity.

Original languageEnglish (US)
Article numberjnis-2023-021243
JournalJournal of neurointerventional surgery
DOIs
StateAccepted/In press - 2024

Keywords

  • Cervical
  • Neck
  • Stenosis
  • Stent
  • Stroke

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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