A Preliminary Study On The Recognition And Clinical Features Of Carotid Web

ObjectiveCarotid web is defined as a diaphragm that originated from the posterior wall of the carotid artery nearby the carotid bifurcation.Carotid web,as a rare risk factor of ischemic stroke,is seldom researched in China.We aim to preliminary explore the diagnosis,clinical features and the treatment of carotid webMethodsWe retrospectively reviewed 5,943 patients who underwent carotid computed tomography angiography screening from August 2014 to February 2018 in the first affiliated hospital Zhejiang University and Zhejiang province Shaoxing second hospital,and found 32 patients with carotid web.We retrospectively evaluate the clinical manifestation,imaging characteristics,treatment and follow-up of discharge from 32 patients recruited.Meanwhile,we summed up and analyzed on the base of the results and referencesResultsWe finally found 32(0.54%)patients(male 18 cases,female 14 cases)in the population of visitors undergoing the check of carotid CTA at the hospitals.There were 14 patients(34.75%)diagnosed as unexplained dizzy,eight patients(25.0%)as ischemic stroke,2 patients(6.25%)as cerebral hemorrhage and 2 patients as syncope.The four ischemic stroke patients were attacked in the territory of the carotid web.The other reasons of admission for 6 patients include anxiety disorder,somatoform disorders,sudden deafness,unexplained weak,preoperative screening and moyamoya disease.For therapy aspects,one case got carotid endarterectomy and the tissue of the vascular wall was fibrosis proliferation with myxoid degeneration,histologically.Two cases were treated with stenting.And 13 asymptomatic patients were not treated for the prevention of ischemic stroke.The included patients were followed by telephone or clinical visit.The mean follow-up period was 20.92±12.36 months and there was no strokes and deaths happened.ConclusionCT angiography can recognize carotid web.Compared with African and European populations,carotid web has a low detection rates in China and has good clinical outcomes.The clinical outcome of asymptomatic carotid web is good relatively.The small sample size and representative of the study is not good enough.The large sample size,long-term clinical trials need to be applied to carotid web.