The frequency of carotid web in cryptogenic stroke and its association with stroke risk factors
Ekin Öykü Baylam Yirmibeş1, Nihat Şengeze1, Burak Gürel2
1Department of Neurology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey.
Background:
The carotid web (CaW) is considered a rare source of cerebral embolism. The aim of this study is to determine the prevalence of CaW, clinical data of CaW cases, risk factors, morphological features of CaW and its relationship with cerebrovascular disease and to contribute to the classification of CaW and the most appropriate treatment approaches in the future.
Methods:
Angiographic images of 1,520 patients who were evaluated with a preliminary diagnosis of cerebrovascular disease and underwent carotid computed tomographic angiography (CTA) and/or digital subtraction angiography (DSA) at Süleyman Demirel University Medical Faculty Hospital and Isparta City Hospital between 2016 and 2022 were examined. 31 CaW patients were included in the study. Radiological imaging, laboratory findings and clinical information of the patients were evaluated retrospectively.
Results:
The prevalence of CaW was found to be 2.03 %. 35.5 % of CaW cases were symptomatic and the most common risk factor in these patients were hypertension. The optimum threshold value for CaW length in symptomatic patients was ≥ 2.86 mm. There was a moderate positive linear relationship between CaW length and the degree of CaW stenosis. The optimum threshold value for the degree of web stenosis in symptomatic patients was determined as ≥ 31.33 %.
Conclusion:
This study showed that some morphological features of CaW increase the risk of stroke. These findings suggest that the evaluation and classification of the morphological features of CaW and the development of risk scoring systems based on these features may be effective in estimating the risk of stroke and planning treatment.
