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Ultrasound diagnosis of the carotid webs. Literature review and a clinical case using modern vector analysis technology

https://doi.org/10.24835/1607-0771-2023-1-56-70

Abstract

Carotid wed (CW) is a rare pathology representing intimal protrusion in the bifurcation of the common carotid or sinus of internal carotid arteries, associated with embolic cryptogenic stroke and high risk of its recurrence despite ongoing antiplatelet therapy. Therefore, accurate and timely diagnosis of this pathology is of utmost importance. Ultrasound is a first-line method, but currently only a few reports are devoted to the ultrasound description of CW, which often leads to missed or misdiagnosis of the disease. This paper describes a case of clinically asymptomatic CW and summarizes the literature data on the ultrasound characteristics of this pathology.

About the Authors

A. O. Chechetkin
Research Center of Neurology
Russian Federation

Аndrey О. Chechetkin – Doct. of Sci. (Med.), Chief Researcher, Head of Ultrasound Diagnostics Department

80-1, Volokolamskoye shosse, Moscow 125367



M. V. Dreval
Research Center of Neurology
Russian Federation

Мarina V. Dreval – Cand. of Sci. (Med.), Research fellow, radiologist

80-1, Volokolamskoye shosse, Moscow 125367



References

1. Zhu С., Li Z., Ju Y., Zhao X. Detection of Carotid Webs by CT Angiography, High-Resolution MRI, and Ultrasound. J. Neuroimaging. 2021; 31 (1): 71–75. http://doi.org/10.1111/jon.12784

2. Ben Z., Wang J., Zhan J., Chen S. Ultrasonic characteristics of carotid webs. Neuroradiology. 2022; 64: 95–98. http://doi.org/10.1007/s00234-021-02757-0

3. Ning B., Zhang D., Sui B., He W. Ultrasound imaging of carotid web with atherosclerosis plaque: a case report. J. Med. Case Rep. 2020; 14 (1): 145. http://doi.org/10.1186/s13256-020-02446-1

4. Guglielmi V., Compagne K.C.J., Sarrami A.H., Sluis W.M., van den Berg L.A., van der Sluijs P.M., Mandell D.M., van der Lugt A., Roos YBWEM, Majoie CBLM, Dippel DWJ, Emmer B.J., van Es ACGM, Coutinho J.M. Assessment of Recurrent Stroke Risk in Patients With a Carotid Web. JAMA Neurol. 2021; 78 (7): 826–833. http://doi.org/10.1001/jamaneurol.2021.1101

5. Haussen D.C., Grossberg J.A., Bouslama M., Pradilla G., Belagaje S., Bianchi N., Allen J.W., Frankel M., Nogueira R.G. Carotid Web (Intimal Fibromuscular Dysplasia) Has High Stroke Recurrence Risk and Is Amenable to Stenting. Stroke. 2017; 48 (11): 3134–3137. http://doi.org/10.1161/STROKEAHA.117.019020

6. Hu H., Zhang X., Zhao J., Li Y., Zhao Y. Transient ischemic attack and carotid web. Am. J. Neuroradiol. 2019; 40 (2): 313–318. http://doi.org/10.3174/ajnr.A5946

7. El-Masri S., Wilson M.M., Kleinig T. Systematic review and meta-analysis of ipsilateral and contralateral carotid web prevalence in embolic supratentorial strokes of undetermined source. J. Clin. Neurosci. 2023; 107: 118–123. http://doi.org/10.1016/j.jocn.2022.12.010

8. Joux J., Chausson N., Jeannin S., Saint-Vil M., Mejdoubi M., Hennequin J.L., Deschamps L., Smadja D., Olindo S. Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke. Stroke. 2014; 45 (12): 3711–3713. http://doi.org/10.1161/STROKEAHA.114.007313

9. Kim S.J., Nogueira R.G., Haussen D.C. Current understanding and gaps in research of carotid webs in ischemic strokes: a review. JAMA Neurol. 2019; 76 (3): 355–361. http://doi.org/10.1001/jamaneurol.2018.3366

10. Compagne K.C.J., van Es ACGM, Berkhemer O.A., Borst J., Roos YBWEM, van Oostenbrugge R.J., van Zwam W.H., Majoie CBLM, Marquering H.A., Dippel DWJ, van der Lugt A., Emmer B.J. Prevalence of carotid web in patients with acute intracranial stroke due to intracranial large vessel occlusion. Radiology. 2018; 286 (3): 1000–1007. http://doi.org/10.1148/radiol.2017170094

11. Madaelil T.P., Grossberg J.A., Nogueira R.G., Anderson A., Barreira C., Frankel M., Haussen D.C. Multimodality Imaging in Carotid Web. Front. Neurol. 2019; 10: 220. http://doi.org/10.3389/fneur.2019.00220

12. Olindo S., Marnat G., Chausson N., Turpinat C., Smadja D., Gaillard N. Carotid webs associated with ischemic stroke. Updated general review and research directions. Rev. Neurol. (Paris). 2021; 177 (6): 627–638. http://doi.org/10.1016/j.neurol.2020.09.007

13. El Mesnaoui R., Nikiema S., Massimbo D., El Mesnaoui A. The carotid diaphragm, an often overlooked cause of stroke by cardiologists. J. Surg. Case Rep. 2022; (7): rjac350. http://doi.org/10.1093/jscr/rjac350

14. Kliewer M.A., Carroll B.A. Ultrasound case of the day. Internal carotid artery web (atypical fibromuscular dysplasia). Radiographics. 1991; 11 (3): 504–505. http://doi.org/10.1148/radiographics.11.3.1852941

15. Raman S., Osborn G.D., Khan P.Y., Winter R.K., Champ C.S., Lewis M.H. Carotid diaphragm: an unusual and easily missed cause of internal carotid artery stenosis. Hosp. Med. 2004; 65 (8): 500–501. http://doi.org/10.12968/hosp.2004.65.8.15500

16. Fu W., Crockett A., Low G., Patel V. Internal Carotid Artery Web: Doppler Ultrasound with CT Angiography correlation. J. Radiol. Case Rep. 2015; 9 (5): 1–6. http://doi.org/10.3941/jrcr.v9i5.2434

17. Wang Y., Li J.C., Lv K., Wang N.L., Sharen G.W., Tan L. A rare diaphragm in the common carotid artery: A first case report and literature review. Medicine (Baltimore). 2017; 96 (28): e7331. http://doi.org/10.1097/MD.0000000000007331

18. Luo X., Li Z. Ultrasonic risk stratification of carotid web. Echocardiography. 2019; 36 (11): 2103– 2107. http://doi.org/10.1111/echo.14521

19. Yang J., Hua Y., Zhou F.B., Tian X., Liu R., Jia L. Ultrasonographic features of carotid web. Chin. J. Med. Ultrasound. (Electronic Edition). 2020; 17: 679–683. http://doi.org/10.3877/cma.j.issn.1672-6448.2020.07.017

20. Bennani H., Alami B., Hajjar C., Quenum L., Haloua M., Boubbou M., Belahcen F., Maâroufi M., Alaoui Lamrani M.Y. Symptomatic carotid web: About a rare ultrasound finding. J. Med. Vasc. 2020; 45 (5): 284–287. http://doi.org/10.1016/j.jdmv.2020.05.004

21. Calle La Rosa P., Ecos R., Otiniano-Sifuentes R.D., Ramírez-Quiñones J., Abanto C., Quispe-Orozco D., Valencia A. Carotid Web Diagnosed by Ultrasound Carotid Duplex in a Patient With Ischemic Stroke. Cureus. 2021; 13 (7): e16330. http://doi.org/10.7759/cureus.16330

22. Wang L., Yang Y. The diagnostic value of ultrasound in carotid web and the characteristics of misdiagnosed cases. Zhonghua Yi Xue Za Zhi. 2022; 102 (37): 2975–2978. http://doi.org/10.3760/cma.j.cn112137-20220221-00348

23. Zhou Q., Li R., Feng S., Qu F., Tao C., Hu W., Zhu Y., Liu X. The Value of Contrast-Enhanced Ultrasound in the Evaluation of Carotid Web. Front. Neurol. 2022; 13: 860979. http://doi.org/10.3389/fneur.2022.860979

24. Fontaine L., Guidolin B., Viguier A., Gollion C., Barbieux M., Larrue V. Ultrasound characteristics of carotid web. J. Neuroimaging. 2022; 32 (5): 894–901. http://doi.org/10.1111/jon.13022

25. Seidel G., Meyer K. Impact of ultrasound contrast agents in cerebrovascular diagnostics. Eur. J. Ultrasound. 2002; 16 (1–2): 81–90. http://doi.org/10.1016/s0929-8266(02)00041-1

26. Hoogi A., Adam D., Hoffman A., Kerner H., Reisner S., Gaitini D. Carotid plaque vulnerability: quantification of neovascularization on contrastenhanced ultrasound with histopathologic correlation. Am. J. Roentgenol. 2011; 196 (2): 431–436. http://doi.org/10.2214/AJR.10.4522

27. Choi P.M., Singh D., Trivedi A., Qazi E., George D., Wong J., Demchuk A.M., Goyal M., Hill M.D., Menon B.K. Carotid webs and recurrent ischemic strokes in the era of CT angiography. Am. J. Neuroradiol. 2015; 36: 2134–2139. http://doi.org/10.3174/ajnr.A4431

28. Haidl H., Cimenti C., Leschnik B., Zach D., Muntean W. Agedependency of thrombin generation measured by means of calibrated automated thrombography (cat). Thromb. Haemost. 2006; 95 (5): 772–775. PMID: 16676066

29. Kalashnikova L.A. Dissection of internal carotid and vertebral arteries: clinical presentation, diagnosis, and treatment. Neurology, neuropsychiatry, psychosomatics. 2013; Suppl. 2: 40–45. http://dx.doi.org/10.14412/2310-1342-2013-2357 (In Russian)

30. Dreval M.V., Popova T.A. Modern imaging of spontaneous internal carotid and vertebral arteries dissection on the extracranial level. Medical Visualization. 2012; 3: 59–69. (In Russian)

31. Cutler J., Campo N., Koch S. B-Flow and B-Mode Ultrasound Imaging in Carotid Fibromuscular Dysplasia. J. Neuroimaging. 2018; 28 (3): 269–272. http://doi.org/10.1111/jon.12498

32. Park C.C., El Sayed R., Risk B.B., Haussen D.C., Nogueira R.G., Oshinski J.N., Allen J.W. Carotid webs produce greater hemodynamic disturbances than atherosclerotic disease: a DSA time-density curve study. J. Neurointerv. Surg. 2022; 14 (7): 729–733. http://doi.org/10.1136/neurintsurg-2021-017588

33. Chaari D., Baud J.M., Deschamps L., Petitjean C., Maurizot A., Chadenat M.L., de Malherbe M., Jaoua A., Pico F. Carotid diaphragm: Atypical fibromuscular dysplasia or atheromatous lesions? Rev. Neurol. (Paris). 2017; 173 (4): 230–233. http://doi.org/10.1016/j.neurol.2017.03.012


Review

For citations:


Chechetkin A.O., Dreval M.V. Ultrasound diagnosis of the carotid webs. Literature review and a clinical case using modern vector analysis technology. Ultrasound & Functional Diagnostics. 2023;(1):56-70. (In Russ.) https://doi.org/10.24835/1607-0771-2023-1-56-70

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