Phair John, Trestman Eric B, Yean Chetra, Lipsitz Evan C
Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Bronx, NY, USA.
Vascular. 2017 Oct;25(5):553-556. doi: 10.1177/1708538116684940. Epub 2017 Feb 21.
Background We report a symptomatic carotid web successfully treated with carotid endarterectomy. A healthy 43-year-old woman presented with acute-onset left-sided weakness. Carotid web was evident on computed tomography angiography as a focal filling defect in the right common carotid artery. This right common carotid artery web extended into the ICA created an eddy resulting in turbulent flow. Subsequent acute embolus formation led to embolization and acute stroke. Method Review of the literature was performed using Medline Plus and PubMed databases. Result The patient underwent carotid endarterectomy with primary closure. Procedure was well tolerated and there was an uneventful recovery. Conclusion Arterial webs are a rare arteriopathy and a usual arrangement of fibromuscular intralumenal in-growth with unclear etiology. It is however, an important potential etiology of stroke in patients without traditional atherosclerotic risk factors. Carotid web and atypical carotid fibromuscular dysplasia should be considered in young, otherwise healthy patients presenting with stroke and without the typical risk factors for atherosclerotic carotid disease and stroke.
背景 我们报告了一例通过颈动脉内膜切除术成功治疗的有症状的颈动脉网。一名43岁健康女性出现急性左侧肢体无力。计算机断层血管造影显示颈动脉网为右颈总动脉的局灶性充盈缺损。这个右颈总动脉网延伸至颈内动脉，形成一个涡流，导致血流紊乱。随后急性栓子形成，导致栓塞和急性卒中。方法 使用Medline Plus和PubMed数据库进行文献回顾。结果 患者接受了颈动脉内膜切除术并一期缝合。手术耐受性良好，恢复顺利。结论 动脉网是一种罕见的动脉病变，是纤维肌肉腔内向内生长的一种常见形式，病因不明。然而，它是没有传统动脉粥样硬化危险因素的患者发生卒中的一个重要潜在病因。对于年轻、无动脉粥样硬化性颈动脉疾病和卒中典型危险因素但出现卒中的健康患者，应考虑颈动脉网和非典型颈动脉纤维肌发育不良。
