Sajedi P I, Gonzalez J N, Cronin C A, Kouo T, Steven A, Zhuo J, Thompson O, Castellani R, Kittner S J, Gandhi D, Raghavan P
From the Departments of Diagnostic Radiology and Nuclear Medicine (P.R., P.I.S., T.K., J.Z.).
Neurology (J.N.G., C.A.C., O.T., S.J.K.).
AJNR Am J Neuroradiol. 2017 Jul;38(7):1399-1404. doi: 10.3174/ajnr.A5208. Epub 2017 May 11.
Carotid webs are intraluminal shelf-like filling defects at the carotid bulb with recently recognized implications in patients with recurrent ischemic stroke. We sought to determine whether carotid webs are an under-recognized cause of "cryptogenic" ischemic stroke and to estimate their prevalence in the general population.
A retrospective review of neck CTA studies in young patients with cryptogenic stroke over the past 6 years ( = 33) was performed to determine the prevalence of carotid webs compared with a control group of patients who received neck CTA studies for reasons other than ischemic stroke ( = 63).
The prevalence of carotid webs in the cryptogenic stroke population was 21.2% (95% CI, 8.9%-38.9%). Patients with symptomatic carotid webs had a mean age of 38.9 years (range, 30-48 years) and were mostly African American (86%) and women (86%). In contrast, only 1.6% (95% CI, 0%-8.5%) of patients in the control group demonstrated a web. Our findings demonstrate a statistically significant association between carotid webs and ischemic stroke (OR = 16.7; 95% CI, 2.78-320.3; = .01).
Carotid webs exhibit a strong association with ischemic stroke, and their presence should be suspected in patients lacking other risk factors, particularly African American women.
颈动脉蹼是位于颈动脉球部的腔内 shelf 样充盈缺损，最近被认为与复发性缺血性卒中患者有关。我们试图确定颈动脉蹼是否是“隐源性”缺血性卒中未被充分认识的原因，并估计其在普通人群中的患病率。
对过去6年中因隐源性卒中就诊的年轻患者（n = 33）的颈部CTA研究进行回顾性分析，以确定颈动脉蹼的患病率，并与因非缺血性卒中原因接受颈部CTA检查的对照组患者（n = 63）进行比较。
隐源性卒中人群中颈动脉蹼的患病率为21.2%（95%CI，8.9%-38.9%）。有症状的颈动脉蹼患者的平均年龄为38.9岁（范围30-48岁），主要为非裔美国人（86%）和女性（86%）。相比之下，对照组中只有1.6%（95%CI，0%-8.5%）的患者有颈动脉蹼。我们的研究结果表明颈动脉蹼与缺血性卒中之间存在统计学上的显著关联（OR = 16.7；95%CI，2.78-320.3；P =.01）。
颈动脉蹼与缺血性卒中有很强的关联，对于缺乏其他危险因素的患者，尤其是非裔美国女性，应怀疑其存在颈动脉蹼。
