Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke
Purpose: Carotid artery web (CaW) is a rare focal fibromuscular dysplasia that can lead to embolic strokes with large vessel occlusion. This condition can be effectively treated with endovascular thrombectomy (EVT). Our study aims to assess the prevalence of CaW among patients with acute ischemic st...
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Elsevier
2024-12-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664624001074 |
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| author | Chi-Ting Chung Chih-Hao Chen Yen-Heng Lin Chang-Jie Cheng Hai-Jui Chu Chuan-Hsiu Fu Kuo-Wei Chen Chung-Wei Lee Sung-Chun Tang Jiann-Shing Jeng |
| author_facet | Chi-Ting Chung Chih-Hao Chen Yen-Heng Lin Chang-Jie Cheng Hai-Jui Chu Chuan-Hsiu Fu Kuo-Wei Chen Chung-Wei Lee Sung-Chun Tang Jiann-Shing Jeng |
| author_sort | Chi-Ting Chung |
| collection | DOAJ |
| description | Purpose: Carotid artery web (CaW) is a rare focal fibromuscular dysplasia that can lead to embolic strokes with large vessel occlusion. This condition can be effectively treated with endovascular thrombectomy (EVT). Our study aims to assess the prevalence of CaW among patients with acute ischemic stroke (AIS) who underwent EVT and to compare the clinical characteristics of CaW with other carotid artery pathologies. Methods: We enrolled consecutive patients with AIS who underwent EVT at a single medical center and two regional teaching hospitals in Taiwan from September 2014 to December 2021. We compared CaW with carotid dissection (CaD) and carotid large artery atherosclerosis (CaLAA) in terms of patient demographics and thrombus histological findings. Results: Of the 576 AIS patients who underwent EVT, four (mean age: 50 years) were diagnosed with CaW, resulting in a prevalence of 0.69%. Among these four patients, three experienced successful reperfusion after EVT and achieved functional independence (defined as a modified Rankin Scale score ≤2) three months post-stroke. Importantly, none of the CaW patients suffered a recurrent stroke within one year. Patients with CaW were younger than those with CaD or CaLAA, and exhibited fewer vascular risk factors. Additionally, CaW was associated with distal occlusion sites. The thrombus composition in CaW patients was similar to that in CaD patients. Conclusion: In conclusion, CaW is a rare finding among Asian patients with carotid artery disease who undergo for AIS. It is more prevalent in younger patients with a limited number of vascular risk factors. |
| format | Article |
| id | doaj-art-542e97eb5923492f91e6ba50fb56b7e5 |
| institution | Kabale University |
| issn | 0929-6646 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-542e97eb5923492f91e6ba50fb56b7e52024-11-27T05:01:40ZengElsevierJournal of the Formosan Medical Association0929-66462024-12-011231212531259Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic strokeChi-Ting Chung0Chih-Hao Chen1Yen-Heng Lin2Chang-Jie Cheng3Hai-Jui Chu4Chuan-Hsiu Fu5Kuo-Wei Chen6Chung-Wei Lee7Sung-Chun Tang8Jiann-Shing Jeng9Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, En Chu Kong Hospital, New Taipei City, TaiwanDepartment of Neurology, National Taiwan University Hospital, Taipei, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital, Taipei, TaiwanDepartment of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, En Chu Kong Hospital, New Taipei City, TaiwanDepartment of Neurology, En Chu Kong Hospital, New Taipei City, TaiwanDepartment of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, TaiwanDivision of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, TaiwanDepartment of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Address: No. 7, Chungshan South Road, Taipei, 100, Taiwan.Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Corresponding author. Department of Neurology, National Taiwan University Hospital Address: No. 7, Chungshan South Road, Taipei, 100, Taiwan.Department of Neurology, National Taiwan University Hospital, Taipei, TaiwanPurpose: Carotid artery web (CaW) is a rare focal fibromuscular dysplasia that can lead to embolic strokes with large vessel occlusion. This condition can be effectively treated with endovascular thrombectomy (EVT). Our study aims to assess the prevalence of CaW among patients with acute ischemic stroke (AIS) who underwent EVT and to compare the clinical characteristics of CaW with other carotid artery pathologies. Methods: We enrolled consecutive patients with AIS who underwent EVT at a single medical center and two regional teaching hospitals in Taiwan from September 2014 to December 2021. We compared CaW with carotid dissection (CaD) and carotid large artery atherosclerosis (CaLAA) in terms of patient demographics and thrombus histological findings. Results: Of the 576 AIS patients who underwent EVT, four (mean age: 50 years) were diagnosed with CaW, resulting in a prevalence of 0.69%. Among these four patients, three experienced successful reperfusion after EVT and achieved functional independence (defined as a modified Rankin Scale score ≤2) three months post-stroke. Importantly, none of the CaW patients suffered a recurrent stroke within one year. Patients with CaW were younger than those with CaD or CaLAA, and exhibited fewer vascular risk factors. Additionally, CaW was associated with distal occlusion sites. The thrombus composition in CaW patients was similar to that in CaD patients. Conclusion: In conclusion, CaW is a rare finding among Asian patients with carotid artery disease who undergo for AIS. It is more prevalent in younger patients with a limited number of vascular risk factors.http://www.sciencedirect.com/science/article/pii/S0929664624001074Acute ischemic strokeCarotid artery diseaseCarotid artery webEndovascular thrombectomy |
| spellingShingle | Chi-Ting Chung Chih-Hao Chen Yen-Heng Lin Chang-Jie Cheng Hai-Jui Chu Chuan-Hsiu Fu Kuo-Wei Chen Chung-Wei Lee Sung-Chun Tang Jiann-Shing Jeng Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke Journal of the Formosan Medical Association Acute ischemic stroke Carotid artery disease Carotid artery web Endovascular thrombectomy |
| title | Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke |
| title_full | Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke |
| title_fullStr | Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke |
| title_full_unstemmed | Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke |
| title_short | Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke |
| title_sort | prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke |
| topic | Acute ischemic stroke Carotid artery disease Carotid artery web Endovascular thrombectomy |
| url | http://www.sciencedirect.com/science/article/pii/S0929664624001074 |
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