Related Experiment Video

Updated: May 27, 2026

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

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

Published on: August 12, 2025

Symptomatic carotid web management: A prospective single-center cohort study

Donia Soulimani1, Ruben Tamazyan2, Maxime Raux3

  • 1Vascular Medicine Department, Saint-Joseph Hospital, Paris, France.

Vascular Diseases (Paris, France)
|May 25, 2026
PubMed

Insights

Carotid web (CaW) is a cause of ischemic stroke (IS). Medical management alone led to recurrent IS, while interventions prevented further events, suggesting combined approaches are superior for symptomatic CaW.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Radiology

Background:

  • Carotid web (CaW), a form of focal intimal dysplasia, is implicated as a cause of embolic ischemic stroke (IS).
  • The optimal treatment strategy for symptomatic CaW remains undetermined.
  • This study addresses the clinical course and management of patients with CaW-related IS.

Purpose of the Study:

  • To evaluate the outcomes of different therapeutic approaches for symptomatic carotid web (CaW).
  • To determine the efficacy of medical management versus interventional strategies in preventing recurrent ischemic stroke (IS).

Main Methods:

  • A prospective, single-center observational cohort study included 32 patients hospitalized for IS with confirmed CaW.
  • Patients were followed prospectively from January 2016 to April 2024.
  • Data on clinical presentation, diagnostic imaging, treatment, and follow-up outcomes were collected.

Main Results:

  • Recurrent IS occurred in 19% of patients on antiplatelet therapy (APT) alone.
  • Interventional procedures (carotid endarterectomy or angioplasty with stenting) were performed in 29 patients with no major complications.
  • No ischemic recurrence or death was reported post-intervention during a mean follow-up of 24 months.

Conclusions:

  • Medical management alone for symptomatic CaW is associated with a risk of recurrent ischemic stroke (IS).
  • A combined interventional approach effectively prevents cerebrovascular events in patients with CaW.
  • Further randomized trials are necessary to establish the preferred revascularization strategy.
Abstract

Keywords:
Carotid endarterectomyCarotid stentCarotid webStroke

Related Concept Videos

Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
Atherosclerosis IV: Nursing Management01:23

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...