1279 Do Carotid Webs Raise the Risk of Ischaemic Stroke? a 12 Year Single Centre Retrospective Study

Abstract

Abstract Aim Carotid webs are a rare type of fibromuscular dysplasia (FMD), thought to be a cause of ischaemic stroke. We aimed to review the presentation and outcomes of patients with carotid webs attending our unit over a 12-year period. Method The cohort of patients with carotid webs who presented to our unit between 2010 and 2021 were identified by electronically interrelating imaging reports (CT/MR/angiogram) for the phase “carotid web”. Images were re-reviewed to confirm the diagnosis. The electronic records for the cohort were also reviewed. Results 60 patients with carotid webs were identified, with an age range of 36 to 92 years (mean age 64 years) and a similar sex distribution (31 male, 29 female). 29 carotid webs were left-sided, 22 were right-sided and 9 were bilateral. None had a pre-event diagnosis of FMD. 27 patients had an ischaemic stroke - 18 in the territory relevant to the web location, 9 in other territories. 1 patient was treated with thrombolysis, 1 with thrombectomy and 1 with thrombolysis and thrombectomy. None underwent carotid intervention. Of the 18 patients with a carotid web on the ipsilateral side to their ischaemic event, none had a repeat event recorded. Conclusions 30% of the cohort had an ischaemic stroke event corresponding to the territory supplied by a carotid artery with a web. Current management of carotid webs leans towards conservative management with antiplatelet therapy. However, these data suggest carotid intervention should be considered in selected cases where stroke symptoms correlate to the laterality of the carotid web.