title: Endarterectomy for a symptomatic carotid web.
abstract: Background We report a symptomatic carotid web successfully treated with carotid endarterectomy. A healthy 43-year-old woman presented with acute-onset left-sided weakness. Carotid web was evident on computed tomography angiography as a focal filling defect in the right common carotid artery. This right common carotid artery web extended into the ICA created an eddy resulting in turbulent flow. Subsequent acute embolus formation led to embolization and acute stroke. Method Review of the literature was performed using Medline Plus and PubMed databases. Result The patient underwent carotid endarterectomy with primary closure. Procedure was well tolerated and there was an uneventful recovery. Conclusion Arterial webs are a rare arteriopathy and a usual arrangement of fibromuscular intralumenal in-growth with unclear etiology. It is however, an important potential etiology of stroke in patients without traditional atherosclerotic risk factors. Carotid web and atypical carotid fibromuscular dysplasia should be considered in young, otherwise healthy patients presenting with stroke and without the typical risk factors for atherosclerotic carotid disease and stroke.
authors.affiliation: Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: John
authors.initials: J
authors.lastname: Phair
authors.affiliation: Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Eric B
authors.initials: EB
authors.lastname: Trestman
authors.affiliation: Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Chetra
authors.initials: C
authors.lastname: Yean
authors.affiliation: Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Evan C
authors.initials: EC
authors.lastname: Lipsitz
mesh_terms: D000328:Adult; D001706:Biopsy; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000072226:Computed Tomography Angiography; D016894:Endarterectomy, Carotid; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D012039:Regional Blood Flow; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color
keywords: Arterial web; carotid; endarterectomy; fibromuscular dysplagia; mixoid degeneration; stoke