Endovascular Stent Placement in Patients with Symptomatic Carotid Web Is Considered a Safe and Effective Step to...

To review the safety and effectiveness of carotid artery stent placement (CAS) in treating symptomatic carotid web (CW) and preventing stroke recurrence.

All adult patients with CW with ipsilateral stroke in this institution from January 2020 to March 2025 were reviewed for demographics, comorbidities, presentation, anatomy, treatment characteristics, hospital course, and 6-month outcomes with recurrence stroke and modified Rankin Scale (mRS) score.

Twelve patients with CW and anterior circulation stroke with a mean age of 45 years (SD ± 12) were included. Ten (83%) patients were female, 2 (17%) were diagnosed with hypercoagulable states, and none had atrial fibrillation. Ten patients (83%) experienced large vessel occlusion (LVO). Eight patients (67%) underwent treatment of CW with CAS, and 4 (33%) had no endovascular treatments. The mean time from LVO thrombectomy to CAS treatment of CW was 5 days. No immediate CAS complications were noted, and none of the patients treated with CAS experienced stroke recurrence within 6-month follow-up (all had mRS scores of <2). Four patients (33%) experienced poor outcomes (mRS score, >2) from recurrent strokes, all (100%) of whom never had their CW treated.

Same hospitalization treatment of CW with CAS after stroke is safe and effective in preventing stroke recurrence. Patients appear to be at high risk for multiple recurrent strokes if not treated within the first 6 months.