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Related Experiment Video

Updated: Nov 2, 2025

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
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Stroke Recurrence in First-Ever Symptomatic Carotid Web: A Cohort Study.

Stephane Olindo1, Nicolas Chausson2, Aissatou Signate3

  • 1Stroke Unit, Bordeaux University Hospital, Bordeaux, France.

Journal of Stroke
|June 9, 2021
PubMed
Summary

Symptomatic carotid web (CaW) poses a high risk of recurrent cerebral ischemic events (CIE), with a 5-year recurrence rate of 27.3% under medical management. Surgical intervention showed promising results, with no observed recurrences post-treatment.

Keywords:
Carotid arteryCarribbean regionCohort studiesFibromuscular dysplasiaIschemic strokeRecurrence

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Area of Science:

  • Neurology
  • Vascular Medicine
  • Fibromuscular Dysplasia Research

Background:

  • Carotid web (CaW), an uncommon intimal anomaly linked to fibromuscular dysplasia, is a recognized cause of ipsilateral cerebral ischemic events (CIE).
  • Patients with symptomatic CaW often face a substantial risk of recurrent CIE, yet robust prospective data remain limited.

Purpose of the Study:

  • To prospectively evaluate the recurrence rate of cerebral ischemic events (CIE) in patients with symptomatic carotid web (CaW).
  • To identify independent predictors associated with CIE recurrence in this patient cohort.

Main Methods:

  • A multicenter observational cohort study included 92 Afro-Caribbean patients with cryptogenic first-ever CIEs (ischemic stroke or transient ischemic attack) and ipsilateral CaW.
  • Follow-up data were collected from January 2008 to March 2019, focusing on CIE recurrences, analyzed using Kaplan-Meier and Cox regression models.

Main Results:

  • Nineteen patients (20.7%) experienced recurrent ipsilateral CIEs during a mean follow-up of 50.5 months.
  • Medical treatment alone resulted in a 5-year cumulative CIE recurrence rate of 27.3%.
  • The presence of silent cerebral infarctions was the sole independent predictor of CIE recurrence (HR, 6.99; P=0.004).

Conclusions:

  • Symptomatic carotid web (CaW) is associated with a significant risk of recurrent cerebral ischemic events (CIE) when managed medically.
  • Surgical intervention or stenting demonstrated potential efficacy in preventing recurrence, though further randomized trials are warranted.