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Abstract：
OBJECTIVE: The baseline characteristics of patients with symptomatic carotid web (CaW) are unclear. We investigate demographic and cerebrovascular risk factors in patients with this overlooked stroke etiology.
METHODS: We identified consecutive patients diagnosed with symptomatic CaW at a comprehensive stroke center from July 2014-December 2018. These patients were matched at a 1:4 ratio (based on age and NIHSS scores) to create a control group of acute ischemic stroke (AIS) patients with non-CaW etiologies from the local GetWithTheGuidelines stroke database.
RESULTS: Thirty patients with symptomatic CaW were compared to 120 AIS patients with non-CaW etiologies. Symptomatic CaW patients were more likely to be female (73.3 vs. 44.2%; p = 0.004) and black (86.7 vs. 64.2%; p = 0.02). Symptomatic CaWs patients had a fewer absolute number of modifiable cerebrovascular risk factors (1.7±1.1 vs. 2.5±1.2; p = 0.002), lower rates of hypertension (43.4 vs. 63.3%; p = 0.04), and a more favorable lipid profile with lower average LDL (89.5±30.3 vs. 111.2±43.7 mg/dL; p = 0.01) and higher average HDL (47.9±11.3 vs. 42.2±13.8 mg/dL; p = 0.01) as compared to strokes with non-CaW etiology. Symptomatic CaW patients were more likely to have a large vessel occlusion (80.0 vs. 51.7%; p = 0.005), despite similar e-ASPECTS between the groups (8.1±2.1 vs. 8.3±2.2; p = 0.30). On multivariable analysis, symptomatic CaW was an independent predictor of independence at discharge (OR 3.72; 95%CI 1.27-10.94).
CONCLUSIONS: A gender and racial predilection of symptomatic CaWs may exist as females and blacks were were found to be more likely affected. Symptomatic CaW patients have a more benign cerebrovascular risk factor profile corroborating the proposed mechanism of local stasis and thromboembolism. Despite presenting more commonly with LVO, symptomatic CaW was associated with good functional outcome, warranting further studies.
METHODS: We identified consecutive patients diagnosed with symptomatic CaW at a comprehensive stroke center from July 2014-December 2018. These patients were matched at a 1:4 ratio (based on age and NIHSS scores) to create a control group of acute ischemic stroke (AIS) patients with non-CaW etiologies from the local GetWithTheGuidelines stroke database.
RESULTS: Thirty patients with symptomatic CaW were compared to 120 AIS patients with non-CaW etiologies. Symptomatic CaW patients were more likely to be female (73.3 vs. 44.2%; p = 0.004) and black (86.7 vs. 64.2%; p = 0.02). Symptomatic CaWs patients had a fewer absolute number of modifiable cerebrovascular risk factors (1.7±1.1 vs. 2.5±1.2; p = 0.002), lower rates of hypertension (43.4 vs. 63.3%; p = 0.04), and a more favorable lipid profile with lower average LDL (89.5±30.3 vs. 111.2±43.7 mg/dL; p = 0.01) and higher average HDL (47.9±11.3 vs. 42.2±13.8 mg/dL; p = 0.01) as compared to strokes with non-CaW etiology. Symptomatic CaW patients were more likely to have a large vessel occlusion (80.0 vs. 51.7%; p = 0.005), despite similar e-ASPECTS between the groups (8.1±2.1 vs. 8.3±2.2; p = 0.30). On multivariable analysis, symptomatic CaW was an independent predictor of independence at discharge (OR 3.72; 95%CI 1.27-10.94).
CONCLUSIONS: A gender and racial predilection of symptomatic CaWs may exist as females and blacks were were found to be more likely affected. Symptomatic CaW patients have a more benign cerebrovascular risk factor profile corroborating the proposed mechanism of local stasis and thromboembolism. Despite presenting more commonly with LVO, symptomatic CaW was associated with good functional outcome, warranting further studies.
摘要：
目的：症状性颈动脉网（CaW）患者的基线特征尚不清楚。我们调查了这种被忽视的卒中病因患者的人口统计学和脑血管危险因素。
方法：我们确定了2014年7月至2018年12月在综合卒中中心诊断为有症状CaW的连续患者。这些患者以1：4的比例（基于年龄和NIHSS评分）进行匹配，以从当地GetWithTheGuidelines卒中数据库中创建具有非CaW病因的急性缺血性卒中（AIS）患者的对照组。
结果：将30例有症状的CaW患者与120例非CaW病因的AIS患者进行了比较。有症状的CaW患者更可能是女性（73.3vs.44.2%；p=0.004)和黑色(86.7vs.64.2%；p=0.02）。有症状的CaWs患者的可改变的脑血管危险因素的绝对数量较少（1.7±1.1vs.2.5±1.2；p=0.002），较低的高血压发病率（43.4vs.63.3%；p=0.04)，和更有利的血脂与较低的平均LDL（89.5±30.3vs.111.2±43.7mg/dL；p=0.01）和更高的平均HDL（47.9±11.3vs.与具有非CaW病因的中风相比，42.2±13.8mg/dL；p=0.01）。有症状的CaW患者更容易出现大血管闭塞（80.0vs.51.7%；p=0.005)，尽管两组之间的e-ASPECTS相似(8.1±2.1vs.8.3±2.2；p=0.30）。在多变量分析中，有症状的CaW是出院时独立性的独立预测因子(OR3.72;95CI1.27-10.94).
结论：有症状的CaWs可能存在性别和种族偏好，因为发现女性和黑人更有可能受到影响。有症状的CaW患者具有更良性的脑血管危险因素特征，证实了所提出的局部淤滞和血栓栓塞的机制。尽管LVO更常见，有症状的CaW与良好的功能结局相关，值得进一步研究。
方法：我们确定了2014年7月至2018年12月在综合卒中中心诊断为有症状CaW的连续患者。这些患者以1：4的比例（基于年龄和NIHSS评分）进行匹配，以从当地GetWithTheGuidelines卒中数据库中创建具有非CaW病因的急性缺血性卒中（AIS）患者的对照组。
结果：将30例有症状的CaW患者与120例非CaW病因的AIS患者进行了比较。有症状的CaW患者更可能是女性（73.3vs.44.2%；p=0.004)和黑色(86.7vs.64.2%；p=0.02）。有症状的CaWs患者的可改变的脑血管危险因素的绝对数量较少（1.7±1.1vs.2.5±1.2；p=0.002），较低的高血压发病率（43.4vs.63.3%；p=0.04)，和更有利的血脂与较低的平均LDL（89.5±30.3vs.111.2±43.7mg/dL；p=0.01）和更高的平均HDL（47.9±11.3vs.与具有非CaW病因的中风相比，42.2±13.8mg/dL；p=0.01）。有症状的CaW患者更容易出现大血管闭塞（80.0vs.51.7%；p=0.005)，尽管两组之间的e-ASPECTS相似(8.1±2.1vs.8.3±2.2；p=0.30）。在多变量分析中，有症状的CaW是出院时独立性的独立预测因子(OR3.72;95CI1.27-10.94).
结论：有症状的CaWs可能存在性别和种族偏好，因为发现女性和黑人更有可能受到影响。有症状的CaW患者具有更良性的脑血管危险因素特征，证实了所提出的局部淤滞和血栓栓塞的机制。尽管LVO更常见，有症状的CaW与良好的功能结局相关，值得进一步研究。
