Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.

<h4>Introduction</h4>The carotid web is a compelling potential mechanism of embolic ischemic stroke. In this study, we aim to determine the prevalence of ipsilateral carotid web in a cohort of ischemic stroke patients and to perform a systematic review and meta-analysis of similar cohort...

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Autores principales:	Brian Mac Grory, Erez Nossek, Michael E Reznik, Matthew Schrag, Mahesh Jayaraman, Ryan McTaggart, Adam de Havenon, Shadi Yaghi, Wuwei Feng, Karen Furie, Anusha Boyanpally
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/cf691ef6e3f54b5a88bb9b97681cd63f
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spelling	oai:doaj.org-article:cf691ef6e3f54b5a88bb9b97681cd63f2021-12-02T20:17:28ZIpsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.1932-620310.1371/journal.pone.0257697https://doaj.org/article/cf691ef6e3f54b5a88bb9b97681cd63f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257697https://doaj.org/toc/1932-6203<h4>Introduction</h4>The carotid web is a compelling potential mechanism of embolic ischemic stroke. In this study, we aim to determine the prevalence of ipsilateral carotid web in a cohort of ischemic stroke patients and to perform a systematic review and meta-analysis of similar cohorts.<h4>Patients & methods</h4>We performed a retrospective, observational, cohort study of acute ischemic stroke patients admitted to a comprehensive stroke center from June 2012 to September 2017. Carotid web was defined on computed tomography angiography (CTA) as a thin shelf of non-calcified tissue immediately distal to the carotid bifurcation. We described the prevalence of carotid artery webs in our cohort, then performed a systematic review and meta-analysis of similar cohorts in the published literature.<h4>Results</h4>We identified 1,435 potentially eligible patients of whom 879 met criteria for inclusion in our analysis. An ipsilateral carotid web was detected in 4 out of 879 (0.45%) patients, of which 4/4 (1.6%) were in 244 patients with cryptogenic stroke and 3/4 were in 66 (4.5%) patients <60 years old with cryptogenic stroke. Our systematic review yielded 3,192 patients. On meta-analysis, the pooled prevalence of ipsilateral carotid web in cryptogenic stroke patients <60 was 13% (95% CI: 7%-22%; I2 = 66.1%). The relative risk (RR) of ipsilateral versus contralateral carotid web in all patients was 2.5 (95% CI 1.5-4.2, p = 0.0009) whereas in patients less than 60 with cryptogenic stroke it was 3.0 (95% CI 1.6-5.8, p = 0.0011).<h4>Discussion</h4>Carotid webs are more common in young patients with cryptogenic stroke than in other stroke subtypes. Future studies concerning the diagnosis and secondary prevention of stroke associated with carotid web should focus on this population.Brian Mac GroryErez NossekMichael E ReznikMatthew SchragMahesh JayaramanRyan McTaggartAdam de HavenonShadi YaghiWuwei FengKaren FurieAnusha BoyanpallyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257697 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Brian Mac Grory Erez Nossek Michael E Reznik Matthew Schrag Mahesh Jayaraman Ryan McTaggart Adam de Havenon Shadi Yaghi Wuwei Feng Karen Furie Anusha Boyanpally Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.
description	<h4>Introduction</h4>The carotid web is a compelling potential mechanism of embolic ischemic stroke. In this study, we aim to determine the prevalence of ipsilateral carotid web in a cohort of ischemic stroke patients and to perform a systematic review and meta-analysis of similar cohorts.<h4>Patients & methods</h4>We performed a retrospective, observational, cohort study of acute ischemic stroke patients admitted to a comprehensive stroke center from June 2012 to September 2017. Carotid web was defined on computed tomography angiography (CTA) as a thin shelf of non-calcified tissue immediately distal to the carotid bifurcation. We described the prevalence of carotid artery webs in our cohort, then performed a systematic review and meta-analysis of similar cohorts in the published literature.<h4>Results</h4>We identified 1,435 potentially eligible patients of whom 879 met criteria for inclusion in our analysis. An ipsilateral carotid web was detected in 4 out of 879 (0.45%) patients, of which 4/4 (1.6%) were in 244 patients with cryptogenic stroke and 3/4 were in 66 (4.5%) patients <60 years old with cryptogenic stroke. Our systematic review yielded 3,192 patients. On meta-analysis, the pooled prevalence of ipsilateral carotid web in cryptogenic stroke patients <60 was 13% (95% CI: 7%-22%; I2 = 66.1%). The relative risk (RR) of ipsilateral versus contralateral carotid web in all patients was 2.5 (95% CI 1.5-4.2, p = 0.0009) whereas in patients less than 60 with cryptogenic stroke it was 3.0 (95% CI 1.6-5.8, p = 0.0011).<h4>Discussion</h4>Carotid webs are more common in young patients with cryptogenic stroke than in other stroke subtypes. Future studies concerning the diagnosis and secondary prevention of stroke associated with carotid web should focus on this population.
format	article
author	Brian Mac Grory Erez Nossek Michael E Reznik Matthew Schrag Mahesh Jayaraman Ryan McTaggart Adam de Havenon Shadi Yaghi Wuwei Feng Karen Furie Anusha Boyanpally
author_facet	Brian Mac Grory Erez Nossek Michael E Reznik Matthew Schrag Mahesh Jayaraman Ryan McTaggart Adam de Havenon Shadi Yaghi Wuwei Feng Karen Furie Anusha Boyanpally
author_sort	Brian Mac Grory
title	Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.
title_short	Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.
title_full	Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.
title_fullStr	Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.
title_full_unstemmed	Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.
title_sort	ipsilateral internal carotid artery web and acute ischemic stroke: a cohort study, systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/cf691ef6e3f54b5a88bb9b97681cd63f
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Ipsilateral internal carotid artery web and acute ischemic stroke: A cohort study, systematic review and meta-analysis.

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