Carotid web stenting: a case report

Abstract

Background: The carotid web is an intraluminal shelf-like projection emanating from the posterior wall of the carotid bifurcation. Carotid web is a relatively rare cause of embolic stroke. The optimal medical and surgical strategies for managing these lesions have not been well established. Case report: A 47-year-old female patient was transported to our hospital soon after sudden onset of left conjugate deviation of the eyes, right-sided severe hemiplegia and total aphasia. Magnetic resonance imaging (MRI) showed a proximal occlusion of the M1 segment of the middle cerebral artery (MCA). We performed mechanical thrombectomy, and complete recanalization was achieved. Computed tomography angiography (CTA) of her neck demonstrated a shelf-like filling deficit emanating from the posterior wall of the left internal carotid artery, and this finding was diagnostic of a carotid web. We suspected it as the cause of embolization and performed carotid stenting. The postoperative course was uneventful, and she had no recurrent stroke during the 1.5 year follow-up period. Conclusion: Carotid web stenting should be considered as one choice of the treatment because of its safety.