Clinical characteristics of carotid webs and prevention measurements of cerebral ischemic stroke caused by carotid webs
10.3760/cma.j.cn115354-20190812-00474
- VernacularTitle:颈动脉蹼的临床特点及其所致缺血性脑卒中的防治措施分析
- Author:
Xiangbo WU
1
;
Hanpei ZHENG
;
Chuang NIE
;
Zhiming KANG
;
Sirui LI
;
Yinghui WANG
;
Yumin LIU
;
Bin MEI
Author Information
1. 武汉大学中南医院神经内科，武汉 430071
- Keywords:
Carotid web;
Ischemic stroke;
Literature review
- From:
Chinese Journal of Neuromedicine
2020;19(4):365-370
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of carotid webs and prevention measurements of cerebral ischemic stroke caused by carotid webs.Methods:The clinical data of three patients with carotid webs admitted to our hospital from October 2017 to January 2019 were retrospectively studied, and publications (208 patients with carotid webs) reported from January 1, 2014 to June 30, 2019 in PubMed, Embase, Wanfang and CNKI databases were collected. The demographic and clinical characteristics of carotid webs and secondary prevention measurements of ischemic stroke caused by carotid webs were analyzed.Results:A total of 211 patients with carotid webs were enrolled, including 68 male (32.2%) and 143 female (67.8%), with an median age of 48 years. Prevalence of risk factors for cerebrovascular disease reported in 148 patients was as follows: hypertension ( n=43, 29.1%), dyslipidemia ( n=19, 12.8%), diabetes mellitus ( n=14, 9.5%), and smoking ( n=12, 8.1%); 89.8% of carotid webs(44/49) caused mild stenosis of carotid artery (stenosis degree<50%). In secondary stroke prevention, the recurrence rate of stroke patients treated with anticoagulation plus antiplatelet was obviously lower than that of patients treated with antiplatelet alone (11.1% vs. 49.3%). No ischemic stroke or surgical complications were noted in 23 patients underwent carotid endarterectomy and 54 patients underwent carotid stent implantation during the mean follow-up period of 12 months (one-60 months) and 11 months (3-144 months), respectively. Conclusions:Carotid web may be a vital risk factor for cryptogenic stroke. Anticoagulation plus antiplatelet is superior to antiplatelet alone in preventing stroke recurrence. Carotid endarterectomy and carotid stent implantation may be the perfect choices for carotid web patients with high risk of stroke recurrence.
