Abstract
Carotid web was recognized as a cause of ischemic stroke. We sought to determine the clinical and imaging profiles of patients with a carotid web as well as its association with TIA. A retrospective review of carotid CT angiography studies and brain MR imaging in patients with TIA during the past 3 years (n = 135) was performed to determine the presence of carotid webs by 2 experienced neuroradiologists according to previously published criteria. Demographics and clinical and imaging characteristics are shown by descriptive statistics for patients with an identified carotid web. The agreement in the detection of carotid webs between 2 neuroradiologists was examined using κ statistics. There were 12 (8.9%) carotid webs at the symptomatic bifurcation and 1 carotid web (0.7%) at the asymptomatic bifurcation, and no hyperintensity was seen on DWI of these 12 patients. Eight of these 12 (75%) patients with a carotid web were women. None of the 12 patients with a carotid web had major risk factors or other causes of TIA. Fair-to-good interobserver agreement (κ = 0.87) was seen for diagnosing a carotid web with CT angiography. The rate (10/12, 83.3%) of short-term recurrent episodes of TIA in patients with TIA with a carotid web was significantly higher than that of patients without a carotid web (15/123, 12.2%) (P < .001). The incidence of carotid web in patients with TIA was 8.9%. There is an association between carotid web and patients with TIA without other identified risks. Carotid web may be an underestimated risk factor for TIA.
Highlights
MethodsA retrospective review of carotid CT angiography studies and brain MR imaging in patients with TIA during the past 3 years (n ϭ 135) was performed to determine the presence of carotid webs by 2 experienced neuroradiologists according to previously published criteria
BACKGROUND AND PURPOSECarotid web was recognized as a cause of ischemic stroke
According to the guidelines proposed by the American Heart Association and American Stroke Association in 2009,1 TIA is defined as a transient episode of neurologic dysfunction caused by focal brain, spinal cord, or retinal ischemia, without acute infarction
Summary
A retrospective review of carotid CT angiography studies and brain MR imaging in patients with TIA during the past 3 years (n ϭ 135) was performed to determine the presence of carotid webs by 2 experienced neuroradiologists according to previously published criteria. Demographics and clinical and imaging characteristics are shown by descriptive statistics for patients with an identified carotid web. The agreement in the detection of carotid webs between 2 neuroradiologists was examined using statistics Patients This retrospective study was approved by the ethics committee of the Sixth People’s Hospital of Shanghai Jiao Tong University; the need for informed consent was waived. An independent review of these studies was performed by 2 experienced neuroradiologists with 6 – 8 years of experience in carotid CTA imaging and analysis. Follow-up brain MR imaging (DWI and FLAIR) was assessed for the presence of stroke
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