Long-Term Outcomes and Management of Atypical Carotid Web in Nonagenarian
Abstract
Internal carotid artery webs (ICAWs) have been described as noninflammatory, nonatherosclerotic shelf-like projections of intimal fibrous tissue which may be the culprit for embolic stroke of unknown origin. Carotid webs are an atypical form of intimal fibromuscular dysplasia (FMD) and internal carotid webs create areas of stagnation and recirculation distal to the web that favor thrombus formation and embolism. Symptomatic carotid webs are conventionally associated with young women presenting with few vascular risk factors and < 50% stenosis in the affected ICA. ICAWs are being described more and more in the vascular literature, but the management of this pathology remains unclear. We describe a rare case of a 90-year-old male who presented with a significantly sclerosed symptomatic right ICAW without evidence of comorbid atherosclerotic disease. The clinical management, intraoperative findings, and postoperative course are described herein. At the age of 90, this patient is the oldest case of symptomatic carotid web recorded in the literature. Successful management with a carotid endarterectomy is an appropriate strategy for treatment even in a nonagenarian. We would favor carotid endarterectomy over carotid artery stenting given the circumferential, fibrotic nature of these lesions.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- A Survey on Knowledge Graphs: Representation, Acquisition, and Applications
- Toxicity of nanomaterials
- The Human Gene Mutation Database: towards a comprehensive repository of inherited mutation data for medical research, genetic diagnosis and next-generation sequencing studies
- Halogen bonding (X‐bonding): A biological perspective
- Biofilm formation at the air–liquid interface by the Pseudomonas fluorescens SBW25 wrinkly spreader requires an acetylated form of cellulose
- Opioid Activation of Toll-Like Receptor 4 Contributes to Drug Reinforcement
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.