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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
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Relationship between carotid web morphology on CT angiography and stroke: A pooled multicenter analysis
Fouzi Bala1,2, Ibrahim Alhabli2, Nishita Singh2,3
1Diagnostic and Interventional Neuroradiology Department, University Hospital of Tours, Tours, France.
Summary
Carotid web (CaW) morphology, including length, thickness, and volume, is associated with stroke risk. Symptomatic CaWs are longer, thicker, and larger than asymptomatic ones, aiding in stroke etiology determination.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Carotid web (CaW) is a known cause of stroke, particularly in younger individuals.
- Uncertainty exists regarding the frequency and specific radiological features of CaW morphology linked to stroke risk.
- This study aimed to identify CaW radiological features on CT angiography associated with ipsilateral stroke.
Purpose of the Study:
- To determine the association between specific radiological features of carotid webs (CaW) and their symptomatic nature (ipsilateral stroke).
- To investigate the frequency of CaW in patients with acute ischemic stroke.
- To differentiate between symptomatic and asymptomatic CaWs based on morphological characteristics.
Main Methods:
- Pooled data from six studies involving patients with acute ischemic stroke.
- Identification and measurement of CaWs using baseline neck CT angiography by experienced readers.
- Assessment of six 2D CaW features (length, thickness, height, base width, distance to wall, angle) and 3D volume.
- Categorization of CaWs as symptomatic or asymptomatic based on stroke laterality and etiology.
Main Results:
- Carotid webs (CaW) were identified in 1.7% (60/3442) of patients.
- Symptomatic CaWs were associated with younger age, lower rates of hypertension, and more intracranial large vessel occlusions compared to asymptomatic CaWs.
- CaW length (aOR 1.84), thickness (aOR 2.31), volume (aOR 1.07 per mm³), and angle (aOR 0.95) were significantly associated with symptomatic CaW after adjusting for covariates.
Conclusions:
- Radiological assessment of CaW morphology is crucial for determining its causal role in ischemic stroke.
- Symptomatic CaWs exhibit distinct morphological characteristics, including greater length, thickness, and volume, and a specific angle relative to the carotid wall compared to asymptomatic CaWs.
- These findings enhance the understanding of CaW as a stroke etiology and inform diagnostic and treatment strategies.
