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Related Experiment Video

Updated: May 26, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

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Published on: August 12, 2025

Symptomatic stratification based on morphological features of carotid web (SCORE-WEB).

Sávio Batista1,2, Mateus Damiani Monteiro1,2, Fadi Nahab1,3

  • 1School of Medicine, Emory University, Atlanta, GA, United States.

Frontiers in Neurology
|May 25, 2026
PubMed
Summary

A new score, SCORE-WEB, effectively predicts symptomatic carotid web (CaW) presentation using anatomical features. This tool aids in stratifying patients with CaW, a fibromuscular disease variant linked to stroke.

Keywords:
carotid web (CaW)fibromuscular dysplasia (FMD)morphologyscorestroke

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Last Updated: May 26, 2026

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A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

Published on: February 7, 2015

Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Background:

  • Carotid web (CaW) is an underrecognized fibromuscular disease variant associated with cryptogenic ischemic stroke.
  • Morphologic features like lesion length and pocket size are linked to symptomatic presentation, but no validated score exists for asymptomatic patients.

Purpose of the Study:

  • To develop and validate a pragmatic prediction score (SCORE-WEB) to stratify asymptomatic patients with carotid web.
  • To identify key morphologic parameters associated with symptomatic CaW presentation.

Main Methods:

  • Cross-sectional analysis of 126 carotid web cases (80 symptomatic, 46 asymptomatic) from a prospectively maintained database.
  • Extracted morphologic parameters from CTA: pre-web angle, pocket area, lesion length, carotid bulb, and distal cervical internal carotid caliber.
  • Developed a multivariable logistic regression model and derived a simplified SCORE-WEB, assessing discriminative performance using ROC curves.

Main Results:

  • Symptomatic CaW lesions exhibited more acute pre-web angles, larger pocket areas, and greater caliber of the carotid bulb and distal cervical internal carotid artery compared to asymptomatic lesions.
  • The multivariable model showed good discrimination for symptomatic presentation (AUC 0.803).
  • The simplified SCORE-WEB achieved an AUC of 0.824, with an optimal cutoff of ≥7 points (sensitivity 0.54, specificity 0.97).

Conclusions:

  • Distinct morphological features collectively determine the symptomatic status of carotid web.
  • The simplified SCORE-WEB demonstrates good discrimination and practical applicability for stratifying CaW patients.
  • Further validation in larger, prospective datasets and investigation of clinical variables are warranted.