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Endarterectomy for a symptomatic carotid web.

John Phair¹, Eric B Trestman¹, Chetra Yean¹

¹Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Bronx, NY, USA.

|March 7, 2017

Summary

A symptomatic carotid web, a rare cause of stroke in young adults, was successfully treated with carotid endarterectomy. This intervention resolved the turbulent flow and prevented further embolization, leading to a full recovery.

Keywords:

Arterial web carotid endarterectomy fibromuscular dysplagia mixoid degeneration stoke

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Area of Science:

Vascular Surgery
Neurology
Radiology

Background:

Carotid webs are rare arteriopathies causing stroke in patients without traditional risk factors.
A symptomatic carotid web can lead to turbulent flow, embolus formation, and acute ischemic stroke.

Observation:

A 43-year-old woman presented with acute stroke symptoms due to a carotid web.
Computed tomography angiography revealed a focal filling defect in the common carotid artery, extending into the internal carotid artery (ICA).

Findings:

Carotid endarterectomy with primary closure was performed to treat the symptomatic carotid web.
The patient experienced a well-tolerated procedure and an uneventful recovery.

Implications:

Carotid webs should be considered in young, healthy stroke patients lacking typical atherosclerotic risk factors.
Atypical carotid fibromuscular dysplasia and carotid webs are important differential diagnoses for cryptogenic stroke.