Extra-Carotid Arterial Webs: A Single-Center Series and Systematic Review
Eric A Grin1, Evan G Stein2, Lara Balick3,4
1Department of Neurosurgery (E.A.G., E.N.), NYU Grossman School of Medicine, New York, NY.
Stroke (Hoboken, N.J.)
|May 6, 2026
Summary
Extra-carotid arterial webs, similar to carotid webs, can cause ischemic stroke. This study characterizes these rare lesions, finding they may be an underrecognized cause of posterior circulation stroke.
Area of Science:
- Vascular Neurology
- Radiology
- Cerebrovascular Disease
Background:
- Carotid webs are known causes of ischemic stroke.
- Extra-carotid arterial webs are less understood but may share similar features.
Purpose of the Study:
- To characterize the clinical and radiographic features of extra-carotid arterial webs.
- To compare these features with known carotid artery webs.
Main Methods:
- Single-center case series and systematic review of published literature.
- Natural language processing of radiology reports to identify potential cases.
- Imaging review with 3D reconstructions and PRISMA-compliant systematic review.
Main Results:
- Identified 4 extra-carotid webs in-house and 22 from literature (total 26 patients).
- Vertebral artery (53.8%) was the most common site, followed by basilar (30.8%) and subclavian (15.4%).
- 10 patients with vertebral/basilar webs presented with posterior circulation stroke; 3 vertebral webs with recurrent stroke were stented.
Conclusions:
- Extra-carotid webs share features with carotid webs, potentially representing a unified disease spectrum.
- Vertebral and basilar artery webs are rare but may be an underrecognized cause of posterior circulation stroke.
- Recognition can broaden stroke differentials, though histopathologic data is lacking.
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