Abstract TP239: The Correlation Between Ultrasound Characteristics of Carotid Web and Ischemic Stroke

Abstract

Objective: Carotid web is one of the etiologic factors contributed to cryptogenic ischemic stroke. This study aimed to analyze the correlation between ultrasound characteristics of carotid web and ischemic stroke (IS). Methods: Patients with carotid web initially examined by ultrasonography (US), confirmed by computed tomography angiography (CTA) subsequently, were retrospectively enrolled from January 2018 to July 2018. All patients were divided into IS group and no IS (NIS) group for comparative analysis. The degree of carotid artery stenosis (CAS) caused by the carotid web, and the angle between web and carotid wall were measured. The incidence of CAS > 50%, web angle < 70°, and the thrombus occurrence between the two groups were compared. Results: A total of 24 patients finally diagnosed with carotid web were enrolled (10 in IS group, 14 in NIS group). The mean age was 57 years (range 30-75 years), 14 patients were male (58.3%). Thirteen patients diagnosed with carotid web through initial US examination (54.2%, 13/24), and all other 11 patients (45.8%) were misdiagnosed as ulcer-plaque (9 patients) and dissection (2 patients) prior to final diagnosis. There was no significant difference in the incidence of CAS > 50% between IS and NIS groups (10% versus 35.7%, P=0.341). The incidence of thrombus occurrence in IS group was higher than NIS group (80% versus 35.7%, P=0.047). In addition, the proportion of web angle ≤ 70° in IS group was higher than NIS group (90% versus 42.9%, P=0.033). Patients with web angle ≤ 70° had a higher incidence of thrombus than those angle > 70° (73.3% versus 22.2%, P=0.033). However, the incidence of CAS > 50% was higher in patients with web angle > 70° (55.6% vs 6.7%, P=0.015). Conclusion: Ultrasonography could evaluate the specific imaging characteristics of carotid web. The web angle > 70° accounted for CAS > 50%. The angle ≤ 70° was related to developing thrombus, which may cause recurrent ischemic stroke.