Discover the critical link between carotid artery web and acute ischemic stroke through the latest findings on its prevalence and clinical features in patients undergoing endovascular thrombectomy.
– by Klaus
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Prevalence and clinical features of carotid artery web in patients undergoing endovascular thrombectomy for acute ischemic stroke.
Chung et al., J Formos Med Assoc 2024
<!– DOI: 10.1016/j.jfma.2024.02.007 //–>
https://doi.org/10.1016/j.jfma.2024.02.007
Ho, ho, ho! Gather around, my dear friends, for I have a tale to tell, not of elves and reindeer, but of a rare condition known as the Carotid artery web (CaW) – a peculiar ailment that could very well belong in the mysterious lands of the North Pole, but instead, dwells within the human body, leading to embolic strokes with large vessel occlusion. But fear not, for like the magic of Christmas, there’s a treatment that brings hope: endovascular thrombectomy (EVT).
In a study as meticulously conducted as the elves making toys, researchers embarked on a journey through the medical records of patients with acute ischemic stroke (AIS) who underwent EVT in Taiwan, from the frosty September of 2014 to the chilly December of 2021. Their quest? To assess the prevalence of CaW among these patients and to compare the clinical characteristics of CaW with other carotid artery pathologies, much like comparing different types of Christmas cookies.
Out of 576 AIS patients who rode the EVT sleigh, four (with a mean age of 50, sprightly young by North Pole standards) were diagnosed with CaW, revealing a prevalence of 0.69% – a number as rare as a white Christmas in the tropics. Among these four, three experienced the miracle of successful reperfusion after EVT and achieved functional independence, a gift truly worth celebrating. And like the joy of Christmas that lingers, none of the CaW patients suffered a recurrent stroke within one year.
These patients with CaW were younger than those with carotid dissection (CaD) or carotid large artery atherosclerosis (CaLAA), and exhibited fewer vascular risk factors, much like how younger children have fewer worries than adults during the holiday season. Additionally, CaW was associated with distal occlusion sites, and the thrombus composition in CaW patients was similar to that in CaD patients, showing that sometimes, things are not as different as they seem.
In conclusion, my dear friends, CaW is a rare finding among Asian patients with carotid artery disease who undergo EVT for AIS. It is more prevalent in younger patients with a limited number of vascular risk factors, reminding us that sometimes, the most special gifts come in the most unexpected packages. So, let’s raise our glasses of milk (or eggnog, if you prefer) to the health professionals and researchers who, like Santa and his elves, work tirelessly to bring hope and healing to all. Merry Christmas and a healthy New Year!