Abstract:
A carotid web is a thin intraluminal protrusion located in the posterolateral wall of the carotid bulb, which might be a risk factor for cryptogenic stroke. The mechanism of ischemic stroke caused by carotid web is still unclear, but it might be related to hemodynamic changes distal to the web, resulting in flow forces and remote embolization of fibrin-based clots. The diagnosis of a carotid web mainly depends on carotid artery imaging examinations. The main therapeutic strategies include medical treatment with oral antiplatelet agents and anticoagulants, and operative treatment, such as carotid endarterectomy and carotid artery stenting. Few cases of acute large-vessel occlusion undergoing mechanical thrombectomy in the setting of carotid web as the etiology have been reported. We report here a case of a 37-year-old woman who underwent stent retriever embolectomy after acute ischemic stroke. Carotid artery imaging examinations, including digital subtraction angiography and magnetic resonance imaging, and pathology showed that a carotid web was located at the proximal right internal carotid artery. We also discuss the clinical pathophysiological and imaging features, and the treatment of carotid web as described in the currently available literature.
摘要:
颈动脉网是位于颈动脉球后外侧壁的管腔内突起,这可能是隐源性中风的危险因素。颈动脉网致缺血性脑卒中的机制尚不清楚,但这可能与网状远端的血液动力学变化有关,导致基于纤维蛋白的凝块的流动力和远程栓塞。颈动脉网的诊断主要取决于颈动脉影像学检查。主要的治疗策略包括口服抗血小板药物和抗凝剂的药物治疗,和手术治疗,如颈动脉内膜切除术和颈动脉支架置入术。很少有病例报道在颈动脉网的背景下进行机械血栓切除术的急性大血管闭塞。我们在此报告一例37岁的女性,该女性在急性缺血性中风后接受了支架取出器栓子切除术。颈动脉成像检查,包括数字减影血管造影和磁共振成像,病理显示,颈动脉网位于右颈内动脉近端。我们还讨论了临床病理生理和影像学特征,以及目前可用文献中描述的颈动脉网的治疗。