Clinical analysis, treatment process and experience of 4 cases of carotid artery web

Abstract

Objectives: Carotid artery web (CaW) is a vascular anomaly linked to cryptogenic ischemic stroke, especially in young patients without traditional vascular risk factors. This study analyzes the clinical characteristics, treatment strategies, and outcomes of four patients diagnosed with CaW.

Methods: A retrospective analysis of four patients diagnosed with CaW from January 2018 to January 2022 was conducted. Treatment strategies varied: two patients received thrombolysis and mechanical embolectomy, while two received mechanical embolectomy alone. All patients were placed on long-term anti-platelet therapy.

Results: The cases consisted of 3 males and one female, with an average age of 48 year; the patients presented with acute ischemic symptoms. Imaging confirmed CaW in each patient, with two undergoing thrombolysis and mechanical embolectomy, and two undergoing mechanical embolectomy alone. Follow-up (12-36 months) showed no recurrence of stroke or ischemic symptoms.

Conclusions: CaW is a significant, though rare, cause of ischemic stroke, especially in middle-aged males. A combined approach of thrombolysis or mechanical embolectomy, followed by long-term anti- platelet therapy, is effective in preventing stroke recurrence. Further studies are needed to establish standardized treatment guidelines.