A Systematic Literature Review of Patients With Carotid Web and Acute Ischemic Stroke.


:Background and Purpose- Carotid web (CW) is a rare form of focal fibromuscular dysplasia defined as an abnormal shelf-like projection of intimal fibrous tissue into the carotid bulb. It is theorized that CW leads to ischemic stroke secondary to blood flow stasis and subsequent embolization. The natural history and optimal management of CW are unclear. To address this knowledge gap, we performed a systematic literature review (SLR) of CW. Methods- Our librarians performed a SLR for CW and related terminology. Patient-level demographics, stroke risk factors, neuroimaging findings, stroke recurrence or stroke free-duration, and treatment modality were extracted. We used descriptive statistics to characterize our results. When specific patient-level metrics were not reported, the denominators for reporting percentage calculations were adjusted accordingly. Results- Our literature search produced 1150 articles. Thirty-seven articles including 158 patients (median age 46 years [range 16-85], 68% women, 76% symptomatic) met entry criteria and were included in our SLR. Of the symptomatic CW patients: 57% did not have stroke risk factors, 56% who received medical therapy had recurrent stroke (median 12 months, range 0-97), and 72% were ultimately treated with carotid revascularization (50% carotid stenting, 50% carotid endarterectomy). There were no periprocedural complications or recurrent strokes in carotid revascularization patients. Conclusions- CW leads to ischemic stroke in younger patients without conventional stroke risk factors. We found a high stroke recurrence rate in medically managed symptomatic CW patients, whereas carotid revascularization effectively prevented recurrent stroke. Our findings should be interpreted with caution because of risk of publication and reporting bias.






Zhang AJ,Dhruv P,Choi P,Bakker C,Koffel J,Anderson D,Kim J,Jagadeesan B,Menon BK,Streib C




Has Abstract


2018-12-01 00:00:00














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    pub_type: 杂志文章


    authors: Lyon JL,Bishop CT,Nielsen NS

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    pub_type: 杂志文章,评审


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    pub_type: 杂志文章


    authors: Dae MW,Gao DW,Ursell PC,Stillson CA,Sessler DI

    更新日期:2003-03-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:1977-11-01 00:00:00

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    pub_type: 杂志文章


    authors: Redfern J,McKevitt C,Dundas R,Rudd AG,Wolfe CD

    更新日期:2000-08-01 00:00:00

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    pub_type: 杂志文章,meta分析


    authors: Wardlaw JM,Sandercock PA,Berge E

    更新日期:2003-06-01 00:00:00

  • ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for Brain Hemorrhage: A Multicenter Randomized Controlled Trial.

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    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Vespa P,Hanley D,Betz J,Hoffer A,Engh J,Carter R,Nakaji P,Ogilvy C,Jallo J,Selman W,Bistran-Hall A,Lane K,McBee N,Saver J,Thompson RE,Martin N,ICES Investigators.

    更新日期:2016-11-01 00:00:00

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    pub_type: 杂志文章


    authors: Jin K,Xie L,Sun F,Mao X,Greenberg DA

    更新日期:2011-09-01 00:00:00

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    pub_type: 杂志文章


    authors: Couture DE,Ellegala DB,Dumont AS,Mintz PD,Kassell NF

    更新日期:2002-04-01 00:00:00

  • Differences between ischemic stroke subtypes in vascular outcomes support a distinct lacunar ischemic stroke arteriopathy: a prospective, hospital-based study.

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    pub_type: 杂志文章


    authors: Jackson CA,Hutchison A,Dennis MS,Wardlaw JM,Lewis SC,Sudlow CL

    更新日期:2009-12-01 00:00:00