Department of Radiology, Montefiore Medical Center, Bronx, New York, USA.
Department of Neurology, Montefiore Medical Center, Bronx, New York, USA.
Clin Anat. 2021 Sep;34(6):867-871. doi: 10.1002/ca.23735. Epub 2021 May 7.
Carotid artery webs are shelf-like protrusions of intimal fibrous tissue arising from the posterior wall of the carotid bulb, found to have a 2.3% prevalence in the United States. Previous studies have demonstrated its association with ipsilateral anterior circulation stroke. The aim of this study is to assess the prevalence of carotid webs in the largest US epidemiologic study to date, and to further characterize the clinical features of carotid web patients. We assembled a cohort of 1467 adult patients with CT angiogram neck from January 1, 2011 to January 1, 2017. CT angiograms were reviewed for diagnosis of carotid web. Demographic and clinical details of web patients were obtained. Differences in demographics and CT angiogram indication between patients with and without carotid web were assessed using appropriate statistical tests. Twenty-four (24/1467 = 1.6%) carotid web patients were identified (mean age: 63 years; 62.5% female; 50% African American). Twelve (12/24 = 50%) had ipsilateral anterior circulation stroke. Of them, 8 were deemed cryptogenic. Four (4/24 = 16.7%) web patients had at least one recurrent stroke in the ipsilateral anterior circulation. One case was reported on the radiology report at the time the study was initially performed. This study confirms a prevalence of 1.6% in our urban, North American cohort. Among carotid web patients, there was a high incidence of ipsilateral anterior circulation stroke, the majority of which were classified as cryptogenic. This study affirms the importance of the diagnosis of carotid web, especially in cryptogenic stroke patients, as a potential unrecognized stroke risk factor.
颈动脉壁是一种从颈动脉球后壁突向管腔的内弹力层纤维组织的架子样突起，在美国的发生率为 2.3%。先前的研究表明，它与同侧前循环卒中有关。本研究旨在评估颈动脉壁在迄今美国最大的流行病学研究中的发生率，并进一步描述颈动脉壁患者的临床特征。我们组建了一个包含 1467 例 CT 血管造影颈部的成年患者队列，时间范围为 2011 年 1 月 1 日至 2017 年 1 月 1 日。对 CT 血管造影进行回顾性分析，以诊断颈动脉壁。获取壁患者的人口统计学和临床特征的详细信息。使用适当的统计检验评估颈动脉壁患者与无颈动脉壁患者之间在人口统计学和 CT 血管造影适应证方面的差异。确定了 24 例颈动脉壁患者（平均年龄：63 岁；62.5%为女性；50%为非裔美国人）。12 例（12/24=50%）有同侧前循环卒中。其中 8 例被认为是隐源性的。4 例（4/24=16.7%）同侧前循环发生了至少一次复发性卒中。在研究最初进行时，在放射学报告中报告了 1 例。本研究证实了我们在城市北美队列中颈动脉壁的发生率为 1.6%。在颈动脉壁患者中，同侧前循环卒中的发生率很高，其中大多数被归类为隐源性。本研究证实了诊断颈动脉壁的重要性，尤其是在隐源性卒中患者中，因为它可能是一个未被认识到的卒中危险因素。
