CAROTID WEB AND ACUTE ISCHEMIC STROKE: CASE REPORT

BACKGROUND AND AIMS:Carotid Web (CW) is a rare variant of fibromuscular dysplasia in which a band of tissue narrows the carotid lumen, and is associated with recurrent ischemic stroke, secondary to blood flow stasis and subsequent embolization. Literature revealed high stroke recurrence rate related to medical treatment whereas carotid stenting seems to be safe and efective in secondary prevention. Nevertheless, evidence and the optimal management is unclear.METHODS:Case report.RESULTS:A 61 year-old male with previous history of smoking and hypertension treated with doxazosin was admitted in our Comprehensive Stroke Center with acute right hemiparesis, hemihypoesthesia and aphasia (NIHSS 9). Non contrast CT and CT angiography showed ASPECTS 10/10 and distal carotid occlusion. CT perfusion revealed ischemic penumbra. He underwent intravenous fibrinolysis and mechanical thrombectomy (TICI 3) with progressive improvement of symptoms. Digital angiography revealed carotid web variant with lumen stenosis of left internal carotid artery (ICA). Prolonged heart rhythm monitoring did not revel any arrytmia. Blood tests including thrombophilya studies and ultrasound echocardiography were normal. Elective angioplasty and stenting of ICA was performed followed by dual antiplatelet therapy with aspirin and clopidogrel. Patient was discharged 11 days after symptoms onset with mild distal paresis of right arm. No recurrence was reportedCONCLUSIONS:There is an association between carotid artery web and ischemic stroke. Angioplasty might be safe a feasible for secondary prevention.

BACKGROUND AND AIMS:Carotid Web (CW) is a rare variant of fibromuscular dysplasia in which a band of tissue narrows the carotid lumen, and is associated with recurrent ischemic stroke, secondary to blood flow stasis and subsequent ...