Carotid endarterectomy for symptomatic carotid web: A case report and review of the literature

Introduction: A carotid web is a shelf-like intraluminal projection located in the carotid bulb, considered a rare variant of fibromuscular dysplasia. It is increasingly recognized as an important cause of recurrent ischemic strokes, particularly in young patients without traditional vascular risk factors. 

Materials and Methods: We report the case of a 50-year-old patient with recurrent transient ischemic attacks despite antiplatelet therapy. Initial cerebral computed tomography was unremarkable. Doppler ultrasound of the supra-aortic trunks demonstrated approximately 70% internal carotid artery stenosis. Subsequent angiographic evaluation identified a carotid web. 

Results: Following multidisciplinary discussion, carotid endarterectomy was performed the patient underwent carotid endarterectomy, with no postoperative complications or recurrence of neurological events over a three-year follow-up period. 

Conclusion: This case highlights the potential role of surgical intervention in preventing recurrence of cerebrovascular events in patients with symptomatic carotid web, supporting emerging evidence favoring interventional management strategies over medical therapy alone. Further studies are needed to establish standardized treatment guidelines.