BACKGROUND A carotid web (CaW) is a shelf-like lesion in the posterior aspect of the internal carotid bulb and represents an intimal variant of fibromuscular dysplasia. CaW has been associated with recurrent strokes and conventionally treated with surgical excision. We report a multicenter experience of stenting in patients with symptomatic CaWs. METHODS Retrospective review of consecutive patients admitted to 5 comprehensive stroke centers who were identified to have a symptomatic CaW and treated with carotid stenting. A symptomatic CaW was defined by the presence of a shelf-like/linear, smooth filling defect in the posterior aspect of the carotid bulb diagnosed by neck CT angiography (CTA) and confirmed with conventional angiography in patients with negative stroke workup. RESULTS Twenty-four patients with stented symptomatic CaW were identified (stroke in 83% and transient ischemic attack in 17%). Their median age was 47 years (IQR 41-61), 14 (58%) were female, and were 17 (71%) black. The degree of stenosis by NASCET was 0% (range 0-11). All patients were placed on dual antiplatelets and stented at a median of 9 days (IQR 4-35) after the last event. Closed-cell stents were used in 18 (75%) of the cases. No periprocedural events occurred with the exception of 2 cases of asymptomatic hypotension/bradycardia. Clinical follow-up after stent placement occurred for a median of 12 months (IQR 3-19) with no new cerebrovascular events noted. Functional independence at 90 days was achieved in 22 (91%) patients. Follow-up vascular imaging (ultrasound n = 18/CTA n = 5) was performed at a median of 10 months (IQR 3-18) and revealed no stenosis. CONCLUSIONS Stenting for symptomatic CaW appears to be a safe and effective alternative to surgical resection. Further studies are warranted.

中文翻译：

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有症状的颈动脉网支架置入术的多中心经验。

背景技术颈动脉网（CaW）是颈内动脉球后部的架状病变，代表肌纤维发育不良的内膜变体。CaW 与复发性中风有关，通常通过手术切除进行治疗。我们报告了在有症状的 CaWs 患者中进行支架置入的多中心经验。方法 回顾性回顾 5 个综合卒中中心收治的连续患者，这些患者被确定为有症状的 CaW 并接受颈动脉支架治疗。有症状的 CaW 定义为颈部 CT 血管造影 (CTA) 诊断的颈动脉球后部存在搁板状/线性平滑充盈缺损，并在中风检查阴性的患者中通过常规血管造影证实。结果 确定了 24 名有支架症状的 CaW 患者（中风占 83%，短暂性脑缺血发作占 17%）。他们的中位年龄为 47 岁（IQR 41-61），14 人（58%）为女性，17 人（71%）为黑人。NASCET 的狭窄程度为 0%（范围 0-11）。所有患者均接受双重抗血小板治疗，并在最后一次事件后的中位时间为 9 天（IQR 4-35）植入支架。18 例（75%）病例使用了闭孔支架。除 2 例无症状性低血压/心动过缓外，未发生围手术期事件。支架置入后的临床随访中位时间为 12 个月（IQR 3-19），未发现新的脑血管事件。22 名 (91%) 患者在 90 天时实现了功能独立。随访血管成像（超声 n = 18/CTA n = 5）在中位 10 个月（IQR 3-18）进行，未发现狭窄。结论 有症状的 CaW 支架置入术似乎是手术切除的一种安全有效的替代方法。有必要进行进一步的研究。