{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:50:23Z","timestamp":1777409423482,"version":"3.51.4"},"reference-count":30,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2019,11,10]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Carotid web (CaW) is a shelf-like linear filling defect in the posterior aspect of the internal carotid bulb, representing an intimal variant of fibromuscular dysplasia. The diagnosis of CaW is traditionally restricted to digital subtraction angiography (DSA), CT\/MR angiography (CTA\/MRA), and Duplex ultrasonography. In this series of patients with acute ischemic stroke, we evaluated the potential utility of intravascular ultrasound (IVUS) in further characterizing suspected CaWs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a case series of three patients with suspected CaW who underwent DSA for treatment or investigation of large vessel occlusion strokes. In all cases the stroke investigation failed to identify an alternative cause, and the stroke etiology was attributed to a symptomatic CaW. The procedure consisted of positioning a guide catheter in the common carotid artery, navigating the IVUS probe distal to the carotid bulb, and then retracting the probe with a manual pullback. The acquired images were then reviewed in an independent workstation<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In two of the three cases, IVUS showed an isoechoic-to-hyperechoic focal eccentric area at the posterior carotid bulb, consistent with CaW. The endoluminal protrusion was inconspicuous on IVUS due to the low resolution of ultrasound not allowing a clear differentiation between fibrosis, thrombosis, and atherosclerosis. No abnormalities commonly associated with atherosclerotic disease or dissections were noted. The CaW could not be depicted in the third patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of IVUS in the diagnosis of CaW may have limited relevance. Continued investigation of other imaging modalities for accurate CaW diagnosis is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2019-015387","type":"journal-article","created":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T22:18:23Z","timestamp":1575497903000},"page":"531-534","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Intravascular Ultrasound in Carotid Web"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0406-4146","authenticated-orcid":false,"given":"Sara","family":"Hassani","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raul G","family":"Nogueira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alhamza R","family":"Al-Bayati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajesh","family":"Sachdeva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McDaniel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diogo C","family":"Haussen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,4]]},"reference":[{"key":"2024111103453705000_12.5.531.1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.013918"},{"key":"2024111103453705000_12.5.531.2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019020"},{"key":"2024111103453705000_12.5.531.3","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1001\/jamaneurol.2018.3366","article-title":"Current understanding and gaps in research of carotid webs in ischemic strokes","volume":"76","author":"Kim","year":"2019","journal-title":"JAMA Neurol"},{"key":"2024111103453705000_12.5.531.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021907"},{"key":"2024111103453705000_12.5.531.5","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4431"},{"key":"2024111103453705000_12.5.531.6","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2019.00220","article-title":"Multimodality imaging in carotid web","volume":"10","author":"Madaelil","year":"2019","journal-title":"Front Neurol"},{"key":"2024111103453705000_12.5.531.7","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-017-1797-z"},{"key":"2024111103453705000_12.5.531.8","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1810"},{"key":"2024111103453705000_12.5.531.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.4.604"},{"key":"2024111103453705000_12.5.531.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.6.2305"},{"key":"2024111103453705000_12.5.531.11","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-010-9789-7"},{"key":"2024111103453705000_12.5.531.12","first-page":"1","article-title":"Intravascular ultrasound to guide percutaneous coronary interventions: an evidence-based analysis","volume":"6","year":"2006","journal-title":"Ont Health Technol Assess Ser"},{"key":"2024111103453705000_12.5.531.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02408-7"},{"key":"2024111103453705000_12.5.531.14","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1002\/ccd.21968","article-title":"Assessment of renal artery fibromuscular dysplasia: angiography, intravascular ultrasound (with virtual histology), and pressure wire measurements","volume":"74","author":"Prasad","year":"2009","journal-title":"Catheter Cardiovasc Interv"},{"key":"2024111103453705000_12.5.531.15","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.1999.1058"},{"key":"2024111103453705000_12.5.531.16","doi-asserted-by":"publisher","DOI":"10.1583\/1074-6218(1996)003<0203:IUAICI>2.0.CO;2"},{"key":"2024111103453705000_12.5.531.17","unstructured":"Qureshi AI , Georgiadis AL . Textbook of Interventional Neurology. Cambridge; New York: Cambridge University Press, 2011."},{"key":"2024111103453705000_12.5.531.18","article-title":"Ultrasonography in carotid webs","volume":"6","author":"Haussen DC","year":"2017","journal-title":"Interv Neurol"},{"key":"2024111103453705000_12.5.531.19","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3400\/avd.cr.11.00029","article-title":"Focal renal arterial fibromuscular dysplasia demonstrated via intravascular ultrasound image","volume":"4","author":"Ogawa","year":"2011","journal-title":"Ann Vasc Dis"},{"key":"2024111103453705000_12.5.531.20","doi-asserted-by":"publisher","DOI":"10.1016\/0301-5629(93)90077-2"},{"key":"2024111103453705000_12.5.531.21","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90472-2"},{"key":"2024111103453705000_12.5.531.22","first-page":"1881","article-title":"Depiction of carotid plaque ulceration and other plaque-related disorders by intravascular sonography: a flow chamber study","volume":"17","author":"Miskolczi","year":"1996","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024111103453705000_12.5.531.23","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.93.6.1206"},{"key":"2024111103453705000_12.5.531.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01799-5"},{"key":"2024111103453705000_12.5.531.25","doi-asserted-by":"crossref","first-page":"8","DOI":"10.15420\/icr.2015.10.1.8","article-title":"Intravascular ultrasound versus optical coherence tomography for coronary artery imaging \u2013 apples and oranges?","volume":"10","author":"Rathod","year":"2015","journal-title":"Interv Cardiol"},{"key":"2024111103453705000_12.5.531.26","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jccase.2015.03.009","article-title":"Intravascular findings of fibromuscular dysplasia on optical coherence tomography","volume":"12","author":"Mizutani","year":"2015","journal-title":"J Cardiol Cases"},{"key":"2024111103453705000_12.5.531.27","doi-asserted-by":"publisher","DOI":"10.1253\/circj.69.903"},{"key":"2024111103453705000_12.5.531.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2011.01.013"},{"key":"2024111103453705000_12.5.531.29","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1002\/ccd.27533","article-title":"Is optical coherence tomography a coherent strategy for carotid artery stenting?","volume":"91","author":"Safian","year":"2018","journal-title":"Catheter Cardiovasc Interv"},{"key":"2024111103453705000_12.5.531.30","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2017-013004"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2019-015387","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T11:47:57Z","timestamp":1731325677000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2019-015387"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,4]]},"references-count":30,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,4,15]]},"published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1136\/neurintsurg-2019-015387"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2019-015387","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,4]]}}}