Carotid Web Stenting

Gouveia, Edna E.; Mathkour, Mansour; Bennett, G; Valle-Giler, Edison P.

doi:10.31486/toj.18.0143

Cited by 12 publications

(4 citation statements)

References 19 publications

(30 reference statements)

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“…In such cases, intimal hyperplasia in the stent may occur later, but ipsilateral ischemic stroke related to the CW cannot occur. Gouveia et al [8] also reported a case of endothelialization on the CW confirmed by DSA at 3 months after stenting. However, to our knowledge there are no other cases with CW endothelialization confirmed earlier than 3 months.…”

Section: Discussionmentioning

confidence: 88%

The endothelialization on carotid web treated with dual layer stent placement: a case report

Ishikawa

Shindo²,

Endo³

et al. 2022

Radiology Case Reports

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Section: Discussionmentioning

confidence: 88%

The endothelialization on carotid web treated with dual layer stent placement: a case report

Ishikawa

Shindo²,

Endo³

et al. 2022

Radiology Case Reports

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“…6 There are several studies and case reports which have advocated CAS for the management of embolic stroke associated with a carotid web. 5,20,24 Haussen et al. evaluated 24 patients with embolic stroke associated with a carotid web, of which 61% were females and 75% were black.…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of carotid revascularization in patients with cerebral embolic strokes associated with carotid webs and histopathology revisited

et al. 2020

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Introduction Carotid web is increasingly recognized as the cause of ischemic embolic strokes in younger patients. The best way to treat carotid web is debatable and carotid artery stenting (CAS) has been reported as a treatment for the carotid web in only a few case series. In this study we evaluate the safety and feasibility of CAS in symptomatic carotid webs and examined the histopathology of a carotid web. Materials and methods At our institution between 2017 and 2019, 10 consecutive patients with symptomatic carotid webs were treated. We retrospectively analyzed the data for patient demographics, clinical presentation, imaging, treatment methodology and follow up. Results All the patients had presented with ipsilateral embolic stroke. The mean age at presentation was 50 years (range 37–71) with seven female and three male patients. All patients underwent CAS except one patient who underwent carotid endarterectomy (CEA). In one stented patient, there was significant hypotension in the post-procedural period lasting a week. The patients were followed for a mean of 5.5 months (range one day-12 months). No recurrent stroke or transient ischemic attack (TIA) occurred. Surgical pathological studies confirmed fibromuscular dysplasia in one specimen. Conclusion In our experience CAS for carotid web is feasible and safe in patients presenting with ischemic embolic strokes.

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“…A carotid web is a thin, shelf-like luminal protrusion of the intimal fibrous tissue in ICA, causing the narrowing of the carotid bulb as a non-atherosclerotic disease of the extracranial carotid vasculature ( 1 ). It was initially reported as a filling defect in 1968 and then gradually depicted as a web-like septum ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic evaluation of endarterectomy and stenting treatments for carotid web

Ren

Liu²,

Chen³

et al. 2022

Front. Cardiovasc. Med.

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Background and purposeA carotid web is a thin, shelf-like luminal protrusion in the internal carotid artery that might cause carotid stenosis and stroke by inducing disturbed flow patterns, thrombosis, and abnormal biomechanical stimulus to the endothelial cells. This study simulated and evaluated how the two main treatments (endarterectomy and stenting) influence hemodynamic environments in the carotid artery and distal carotid siphon arteries, aiming to provide more references for the selection of clinical treatment.Materials and methodsThe carotid web, endarterectomy, and stenting models were reconstructed based on CT images. The blood flow simulations were conducted, and critical parameters related to thrombosis formation and artery remodeling, including swirling strength, wall shear stress (WSS), vortex Q-criterion, and oscillating shear index (OSI), were analyzed.ResultsIn the model of the carotid web, obvious recirculation formed distal to the web, accompanied by lower velocity, lower WSS, higher relative resident time (RRT), and higher Q value. While in both two treatment models, the velocity increased and the Q value and RRT decreased at the carotid bifurcation. In addition, both treatments provide more kinetic energy to the distal carotid siphon artery, especially the stenting model.ConclusionThe carotid web can significantly influence the flow environments in the carotid artery. Both endarterectomy and stenting treatments could significantly diminish the side effects of the web and are feasible choices for web patients in terms of hemodynamics. Besides, the treatments for the carotid web would also influence the flow patterns at the distal carotid siphon, especially for the stenting treatment. But more innovational designs are needed to make the minimally invasive stenting treatment more beneficial.

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Carotid Web Stenting

Cited by 12 publications

References 19 publications

The endothelialization on carotid web treated with dual layer stent placement: a case report

The endothelialization on carotid web treated with dual layer stent placement: a case report

Safety and feasibility of carotid revascularization in patients with cerebral embolic strokes associated with carotid webs and histopathology revisited

Hemodynamic evaluation of endarterectomy and stenting treatments for carotid web

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