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ENDARTERECTOMY FOR SYMPTOMATIC CAROTID WEB: A CASE REPORT
John Phair MD¹ Eric Trestman MD¹ Ratna Medicherla MD¹ Evan C. Lipsitz MD¹
a.
Division of Vascular and Endovascular Surgery, Montefiore Medical Center, Department of Surgery, Bronx, NY
Keywords: Carotid Stenosis; Carotid Endarterectomy; Fibromuscular Dysplagia
Corresponding Author:
John Phair, MD
Division of Vascular and Endovascular Surgery
3400 Bainbridge 4^th Fl
Bronx, NY 10467
jphair.org
OBJECTIVES –
To report a symptomatic carotid web, a rare entity histologically related to fibromuscular dysplagia, successfully treated with carotid endarterectomy.
METHODS –
An extensive literature search was performed using the MEDLINE and Pubmed databases with few results in regards to symptomatic carotid web. The few reports in existing literature describe anomoulus malformation of the internal carotid typically found incidentally. Even fewer cases in publication detail symptomatic carotid web lesions. No publications describe a common carotid web. The following search terms were used: carotid web, symptomatic carotid stenosis, fibromuscular dysplagia, endarterectomy and stroke. .
RESULTS – Case report: We report a case of a right common carotid web extending into the internal carotid artery creating an area of flow disruption, resultant in acute embolus formation and stroke. The diagnosis was evident with computed tomographic angiography results. This patient's condition was successfully managed with traditional carotid endarterectomy of the diseased segment.
CONCLUSIONS – This is case represents the rare entity of a symptomatic carotid web. Arterial webs are an unusual arrangement of fibromuscular intralumenal in-growth. The creation of a steep intralumenal shelf within the neurovascular vessels creates a flow disturbance resulting in the risk of symptomatic or potentially catastrophic disease.