Clinical neurology and neurosurgery · 2026
Incidental carotid webs in trauma patients.
СтатьяНазвание и аннотация: Перевод в очереди
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Ferreira Felipe M, Viana Lorena S, Batista Savio, Yelam Theja, Nogueira Raul G, Al-Bayati Alhamza R, Allen Jason W, Park Charlie C, Bhatt Nirav, Frankel Michael R, Haussen Diogo C
Аннотация
INTRODUCTION: Carotid web (CaW) is notably prevalent among young patients with cryptogenic stroke. Data investigating its occurrence in asymptomatic individuals remains scarce. We evaluated the prevalence of CaWs in a cohort of trauma patients.
METHODS: Cross sectional retrospective analysis of consecutive patients who underwent thin-cut neck CT angiograms between October 2015 and August 2018 at a Level 1 Trauma Center. The scans were independently reviewed by two fellowship-trained vascular neurologists who were blinded to demographics and clinical information, and all CaW were reviewed by a fellowship-trained neurointerventionist.
RESULTS: A total of 1157 CTAs in consecutive trauma patients were identified within the study period, and 998 were included. The median age was 39 years [IQR 27.0 - 55.0], 621 (61.3 %) were males, and 626 (62.7 %) were identified as Black or African Americans. 912 (91.4 %) patients had one CTA and 86 (8.6 %) patients had 2 or more CTAs available for review. 1320 (66.1 %) normal carotid bulbs were observed while 16 carotids were found to have a CaW (0.8 % of all carotids) in 15 patients (1.5 % of patients), in which 1 patient had bilateral webs. The lesion involved the postero-lateral carotid bulb wall in 46.7 % of cases, followed by posterior involvement in 33.3 %, postero-medial in 13.3 %, and anterior in 6.7 %. The mean web length was 2.6 ± 0.9 millimeters. Atherosclerotic lesions were otherwise identified in 484 carotid bulbs (24.2 % of all carotid arteries), affecting 394 patients (39.5 %) CONCLUSION: Incidental CaW were identified in 1.5 % of trauma patients undergoing CTA. Incidental CaW may be more common than previously recognized and underscore the need for further studies to determine its clinical relevance.
METHODS: Cross sectional retrospective analysis of consecutive patients who underwent thin-cut neck CT angiograms between October 2015 and August 2018 at a Level 1 Trauma Center. The scans were independently reviewed by two fellowship-trained vascular neurologists who were blinded to demographics and clinical information, and all CaW were reviewed by a fellowship-trained neurointerventionist.
RESULTS: A total of 1157 CTAs in consecutive trauma patients were identified within the study period, and 998 were included. The median age was 39 years [IQR 27.0 - 55.0], 621 (61.3 %) were males, and 626 (62.7 %) were identified as Black or African Americans. 912 (91.4 %) patients had one CTA and 86 (8.6 %) patients had 2 or more CTAs available for review. 1320 (66.1 %) normal carotid bulbs were observed while 16 carotids were found to have a CaW (0.8 % of all carotids) in 15 patients (1.5 % of patients), in which 1 patient had bilateral webs. The lesion involved the postero-lateral carotid bulb wall in 46.7 % of cases, followed by posterior involvement in 33.3 %, postero-medial in 13.3 %, and anterior in 6.7 %. The mean web length was 2.6 ± 0.9 millimeters. Atherosclerotic lesions were otherwise identified in 484 carotid bulbs (24.2 % of all carotid arteries), affecting 394 patients (39.5 %) CONCLUSION: Incidental CaW were identified in 1.5 % of trauma patients undergoing CTA. Incidental CaW may be more common than previously recognized and underscore the need for further studies to determine its clinical relevance.