{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:43:28Z","timestamp":1792806208615,"version":"4.5.0"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Carotid webs (CWs) have increasingly been recognized as a cause of recurrent ischemic stroke. However, the natural history and clinical course of CWs remain unclear. The authors aimed to clarify the prevalence, imaging features, and optimal treatment of CWs in a Japanese cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A series of 444 consecutive Japanese patients who had undergone CTA of the head and neck between April 2011 and October 2016 was retrospectively reviewed. CW was diagnosed on CT angiograms as a membrane-like intraluminal filling defect along the posterior wall of the carotid bulb or the origin of the internal carotid artery (ICA) on oblique sagittal images and a corresponding thin septum on axial images.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Two patients with CWs were identified among 132 patients with suspected stroke. The prevalence of CWs among symptomatic patients with suspected stroke was 1.5%. The prevalence of asymptomatic CWs was 2.2% (7 of 312 cases). The CWs were located in the posterior wall of the carotid bulb in 7 patients and just distal to the ICA origin in 2 patients. There were no apparent differences in the location or lesion length between symptomatic and asymptomatic CWs. Four of the 7 asymptomatic CWs remained asymptomatic for at least 2 years of follow-up. Two patients with symptomatic CWs developed recurrent cerebral infarction and transient ischemic attack despite being on a regimen of oral antiplatelet agents, and carotid endarterectomy was performed as radical treatment. Patients with CWs were younger than controls (median age 55 vs 69 years, p = 0.003) and were less frequently male than controls (33% vs 72%, p = 0.025). CW cases showed significantly fewer common atherosclerosis risk factors than the control group (p &lt; 0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although limited to CTA patients, this study reported on the prevalence and common site of CWs, focusing on symptomatic and asymptomatic Japanese patients. Extensive cross-sectional and prospective observational studies are warranted to elucidate the overall prevalence and natural history of CWs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2020.8.jns201727","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T02:50:20Z","timestamp":1614912620000},"page":"1370-1376","source":"Crossref","is-referenced-by-count":24,"title":["Prevalence and site of predilection of carotid webs focusing on symptomatic and asymptomatic Japanese patients"],"prefix":"10.3171","volume":"135","author":[{"given":"Tao","family":"Yang","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumichi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takakuni","family":"Maki","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyofumi","family":"Yamada","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masakazu","family":"Okawa","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Takayama","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Am J Roentgenol Radium Ther Nucl Med","doi-asserted-by":"publisher","first-page":"550","DOI":"10.2214\/ajr.118.3.550","article-title":"Non-atheromatous stenosis and occlusion of the internal carotid artery and its main branches","volume":"118","author":"Momose KJ","year":"1973","unstructured":"Momose KJ, New PF.Non-atheromatous stenosis and occlusion of the internal carotid artery and its main branches. Am J Roentgenol Radium Ther Nucl Med. 1973;118(3):550\u2013566.10.2214\/ajr.118.3.5504198748"},{"issue":"11","key":"b2","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.3174\/ajnr.A4431","article-title":"Carotid webs and recurrent ischemic strokes in the era of CT angiography","volume":"36","author":"Choi PM","year":"2015","unstructured":"Choi PM, Singh D, Trivedi A,  Carotid webs and recurrent ischemic strokes in the era of CT angiography. AJNR Am J Neuroradiol. 2015;36(11):2134\u20132139.10.3174\/ajnr.A443126228877"},{"issue":"10","key":"b3","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2641","DOI":"10.1161\/STROKEAHA.116.013918","article-title":"Association between carotid bulb diaphragm and ischemic stroke in young Afro-Caribbean patients: a population-based case-control study","volume":"47","author":"Joux J","year":"2016","unstructured":"Joux J, Boulanger M, Jeannin S,  Association between carotid bulb diaphragm and ischemic stroke in young Afro-Caribbean patients: a population-based case-control study. Stroke. 2016;47(10):2641\u20132644.10.1161\/STROKEAHA.116.01391827625379"},{"key":"b4","series-title":"Front Neurol","doi-asserted-by":"publisher","first-page":"220","DOI":"10.3389\/fneur.2019.00220","article-title":"Multimodality imaging in carotid web","volume":"10","author":"Madaelil TP","year":"2019","unstructured":"Madaelil TP, Grossberg JA, Nogueira RG,  Multimodality imaging in carotid web. Front Neurol. 2019;10:220.10.3389\/fneur.2019.0022030915028"},{"issue":"7","key":"b5","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.3174\/ajnr.A5208","article-title":"Carotid bulb webs as a cause of \u201ccryptogenic\u201d ischemic stroke","volume":"38","author":"Sajedi PI","year":"2017","unstructured":"Sajedi PI, Gonzalez JN, Cronin CA,  Carotid bulb webs as a cause of \u201ccryptogenic\u201d ischemic stroke. AJNR Am J Neuroradiol. 2017;38(7):1399\u20131404.10.3174\/ajnr.A520828495950"},{"issue":"11","key":"b6","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3134","DOI":"10.1161\/STROKEAHA.117.019020","article-title":"Carotid web (intimal fibromuscular dysplasia) has high stroke recurrence risk and is amenable to stenting","volume":"48","author":"Haussen DC","year":"2017","unstructured":"Haussen DC, Grossberg JA, Bouslama M,  Carotid web (intimal fibromuscular dysplasia) has high stroke recurrence risk and is amenable to stenting. Stroke. 2017;48(11):3134\u20133137.2901813310.1161\/STROKEAHA.117.019020"},{"issue":"4","key":"b7","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1002\/ana.23953","article-title":"Long-term risk of recurrent vascular events after young stroke: the FUTURE study","volume":"74","author":"Rutten-Jacobs LC","year":"2013","unstructured":"Rutten-Jacobs LC, Maaijwee NA, Arntz RM,  Long-term risk of recurrent vascular events after young stroke: the FUTURE study. Ann Neurol. 2013;74(4):592\u2013601.10.1002\/ana.2395323776015"},{"issue":"1","key":"b8","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1161\/01.STR.22.1.94","article-title":"Recurrent transient ischemic attacks and stroke in association with an internal carotid artery web","volume":"22","author":"Morgenlander JC","year":"1991","unstructured":"Morgenlander JC, Goldstein LB.Recurrent transient ischemic attacks and stroke in association with an internal carotid artery web. Stroke. 1991;22(1):94\u201398.198767710.1161\/01.STR.22.1.94"},{"issue":"4","key":"b9","series-title":"Eur J Neurol","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1111\/ene.12343","article-title":"Diaphragms of the carotid and vertebral arteries: an under-diagnosed cause of ischaemic stroke","volume":"21","author":"Lenck S","year":"2014","unstructured":"Lenck S, Labeyrie MA, Saint-Maurice JP,  Diaphragms of the carotid and vertebral arteries: an under-diagnosed cause of ischaemic stroke. Eur J Neurol. 2014;21(4):586\u2013593.2444760110.1111\/ene.12343"},{"issue":"4","key":"b10","series-title":"Interv Neuroradiol","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1177\/1591019916633245","article-title":"Neurointerventional management of carotid webs associated with recurrent and acute cerebral ischemic syndromes","volume":"22","author":"Elmokadem AH","year":"2016","unstructured":"Elmokadem AH, Ansari SA, Sangha R,  Neurointerventional management of carotid webs associated with recurrent and acute cerebral ischemic syndromes. Interv Neuroradiol. 2016;22(4):432\u2013437.2692297610.1177\/1591019916633245"},{"issue":"5","key":"b11","series-title":"J Radiol Case Rep","first-page":"1","article-title":"Internal carotid artery web: Doppler ultrasound with CT angiography correlation","volume":"9","author":"Fu W","year":"2015","unstructured":"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\u20136.26622927"},{"issue":"12","key":"b12","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"3711","DOI":"10.1161\/STROKEAHA.114.007313","article-title":"Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke","volume":"45","author":"Joux J","year":"2014","unstructured":"Joux J, Chausson N, Jeannin S,  Carotid-bulb atypical fibromuscular dysplasia in young Afro-Caribbean patients with stroke. Stroke. 2014;45(12):3711\u20133713.2535869510.1161\/STROKEAHA.114.007313"},{"issue":"2","key":"b13","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"313","DOI":"10.3174\/ajnr.A5946","article-title":"Transient ischemic attack and carotid web","volume":"40","author":"Hu H","year":"2019","unstructured":"Hu H, Zhang X, Zhao J,  Transient ischemic attack and carotid web. AJNR Am J Neuroradiol. 2019;40(2):313\u2013318.3065525810.3174\/ajnr.A5946"},{"key":"b14","series-title":"Front Neurol","doi-asserted-by":"publisher","first-page":"99","DOI":"10.3389\/fneur.2020.00099","article-title":"A case of ischemic stroke with congenital protein C deficiency and carotid web successfully treated by anticoagulant and carotid stenting","volume":"11","author":"Watanabe S","year":"2020","unstructured":"Watanabe S, Matsumoto S, Nakahara I,  A case of ischemic stroke with congenital protein C deficiency and carotid web successfully treated by anticoagulant and carotid stenting. Front Neurol. 2020;11:99.3213296910.3389\/fneur.2020.00099"},{"issue":"10","key":"b15","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"2583","DOI":"10.1007\/s00701-020-04272-2","article-title":"Carotid web leads to new thrombus formation: computational fluid dynamic analysis coupled with histological evidence","volume":"162","author":"Ozaki D","year":"2020","unstructured":"Ozaki D, Endo T, Suzuki H,  Carotid web leads to new thrombus formation: computational fluid dynamic analysis coupled with histological evidence. Acta Neurochir (Wien). 2020;162(10):2583\u20132588.10.1007\/s00701-020-04272-232152755"},{"issue":"12","key":"b16","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2872","DOI":"10.1161\/STROKEAHA.118.021907","article-title":"A systematic literature review of patients with carotid web and acute ischemic stroke","volume":"49","author":"Zhang AJ","year":"2018","unstructured":"Zhang AJ, Dhruv P, Choi P,  A systematic literature review of patients with carotid web and acute ischemic stroke. Stroke. 2018;49(12):2872\u20132876.3057143010.1161\/STROKEAHA.118.021907"},{"issue":"3","key":"b17","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1148\/radiol.2017170094","article-title":"Prevalence of carotid web in patients with acute intracranial stroke due to intracranial large vessel occlusion","volume":"286","author":"Compagne KCJ","year":"2018","unstructured":"Compagne KCJ, van Es ACGM, Berkhemer OA,  Prevalence of carotid web in patients with acute intracranial stroke due to intracranial large vessel occlusion. Radiology. 2018;286(3):1000\u20131007.2904004010.1148\/radiol.2017170094"},{"issue":"3","key":"b18","series-title":"JAMA Neurol","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1001\/jamaneurol.2018.3366","article-title":"Current understanding and gaps in research of carotid webs in ischemic strokes: a review","volume":"76","author":"Kim SJ","year":"2019","unstructured":"Kim SJ, Nogueira RG, Haussen DC.Current understanding and gaps in research of carotid webs in ischemic strokes: a review. JAMA Neurol. 2019;76(3):355\u2013361.10.1001\/jamaneurol.2018.336630398546"},{"issue":"1","key":"b19","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1212\/WNL.0000000000003464","article-title":"Carotid artery web and ischemic stroke: a case-control study","volume":"88","author":"Coutinho JM","year":"2017","unstructured":"Coutinho JM, Derkatch S, Potvin AR,  Carotid artery web and ischemic stroke: a case-control study. Neurology. 2017;88(1):65\u201369.10.1212\/WNL.000000000000346427864523"},{"issue":"1","key":"b20","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1161\/01.STR.15.1.56","article-title":"Cerebral angiographic and clinical differences in carotid system transient ischemic attacks between American Caucasian and Japanese patients","volume":"15","author":"Nishimaru K","year":"1984","unstructured":"Nishimaru K, McHenry LC Jr, Toole JF.Cerebral angiographic and clinical differences in carotid system transient ischemic attacks between American Caucasian and Japanese patients. Stroke. 1984;15(1):56\u201359.669543110.1161\/01.STR.15.1.56"},{"issue":"2","key":"b21","series-title":"J Vasc Surg","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1016\/j.jvs.2012.08.118","article-title":"The prevalence of carotid artery stenosis varies significantly by race","volume":"57","author":"Rockman CB","year":"2013","unstructured":"Rockman CB, Hoang H, Guo Y,  The prevalence of carotid artery stenosis varies significantly by race. J Vasc Surg. 2013;57(2):327\u2013337.10.1016\/j.jvs.2012.08.11823177534"},{"issue":"1","key":"b22","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1161\/01.STR.15.1.50","article-title":"Flow patterns in the human carotid artery bifurcation","volume":"15","author":"Motomiya M","year":"1984","unstructured":"Motomiya M, Karino T.Flow patterns in the human carotid artery bifurcation. Stroke. 1984;15(1):50\u201356.669543010.1161\/01.STR.15.1.50"},{"issue":"21","key":"b23","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.1001\/jama.282.21.2035","article-title":"Hemodynamic shear stress and its role in atherosclerosis","volume":"282","author":"Malek AM","year":"1999","unstructured":"Malek AM, Alper SL, Izumo S.Hemodynamic shear stress and its role in atherosclerosis. JAMA. 1999;282(21):2035\u20132042.1059138610.1001\/jama.282.21.2035"},{"issue":"25","key":"b24","series-title":"J Am Coll Cardiol","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1016\/j.jacc.2007.02.059","article-title":"Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior","volume":"49","author":"Chatzizisis YS","year":"2007","unstructured":"Chatzizisis YS, Coskun AU, Jonas M,  Role of endothelial shear stress in the natural history of coronary atherosclerosis and vascular remodeling: molecular, cellular, and vascular behavior. J Am Coll Cardiol. 2007;49(25):2379\u20132393.10.1016\/j.jacc.2007.02.05917599600"},{"issue":"5","key":"b25","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1161\/01.STR.28.5.993","article-title":"In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis","volume":"28","author":"Gnasso A","year":"1997","unstructured":"Gnasso A, Irace C, Carallo C,  In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis. Stroke. 1997;28(5):993\u2013998.915864010.1161\/01.STR.28.5.993"},{"issue":"4","key":"b26","series-title":"AJNR Am J Neuroradiol","first-page":"703","article-title":"Flow patterns in carotid webs: a patient-based computational fluid dynamics study","volume":"40","author":"Compagne KCJ","year":"2019","unstructured":"Compagne KCJ, Dilba K, Postema EJ,  Flow patterns in carotid webs: a patient-based computational fluid dynamics study. AJNR Am J Neuroradiol. 2019;40(4):703\u2013708.30872422"},{"issue":"2","key":"b27","series-title":"Vasa","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1024\/0301-1526.30.2.101","article-title":"Variable extension of the transitional zone in the medial structure of carotid artery tripod","volume":"30","author":"Janzen J","year":"2001","unstructured":"Janzen J, Lanzer P, Rothenberger-Janzen K, Vuong PN.Variable extension of the transitional zone in the medial structure of carotid artery tripod. Vasa. 2001;30(2):101\u2013106.10.1024\/0301-1526.30.2.10111417279"},{"issue":"5","key":"b28","series-title":"J Vasc Res","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1159\/000159102","article-title":"Mechanotransduction by vascular smooth muscle","volume":"32","author":"Osol G","year":"1995","unstructured":"Osol G.Mechanotransduction by vascular smooth muscle. J Vasc Res. 1995;32(5):275\u2013292.757879610.1159\/000159102"},{"issue":"9","key":"b29","series-title":"Arch Mal Coeur Vaiss","first-page":"909","article-title":"The microscopic transitional zone between elastic and muscular arteries","volume":"97","author":"Janzen J","year":"2004","unstructured":"Janzen J.The microscopic transitional zone between elastic and muscular arteries. Arch Mal Coeur Vaiss. 2004;97(9):909\u2013914.15521485"},{"issue":"5","key":"b30","series-title":"Ann Vasc Surg","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/S0890-5096(06)61448-9","article-title":"The carotid web: a developmental anomaly of the brachiocephalic system","volume":"1","author":"McNamara MF","year":"1987","unstructured":"McNamara MF.The carotid web: a developmental anomaly of the brachiocephalic system. Ann Vasc Surg. 1987;1(5):595\u2013597.333300910.1016\/S0890-5096(06)61448-9"},{"issue":"5","key":"b31","series-title":"Vascular","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1177\/1708538116684940","article-title":"Endarterectomy for a symptomatic carotid web","volume":"25","author":"Phair J","year":"2017","unstructured":"Phair J, Trestman EB, Yean C, Lipsitz EC.Endarterectomy for a symptomatic carotid web. Vascular. 2017;25(5):553\u2013556.2826418210.1177\/1708538116684940"},{"key":"b32","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"879.e9","DOI":"10.1016\/j.wneu.2016.11.050","article-title":"Stent placement for carotid web","volume":"98","author":"Martinez-Perez R","year":"2017","unstructured":"Martinez-Perez R, Lownie SP, Pandey SK, Boulton MR.Stent placement for carotid web. World Neurosurg. 2017;98:879.e9\u2013879.e11.10.1016\/j.wneu.2016.11.05027876658"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/135\/5\/article-p1370.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/135\/5\/article-p1370.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/135\/5\/article-p1370.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:17:50Z","timestamp":1792804670000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/135\/5\/article-p1370.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":32,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2020.8.jns201727","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}