A study on the CTA imaging characteristics and mechanism of carotid webbing with acute internal carotid artery occlusion

LI Huan; ZHANG Jian

doi:10.20258/j.cnki.1006-9011.2025.05.006

Abstract：Objective To summarize the imaging manifestations of CTA with carotid web and acute internal carotid artery oc-clusion,to analyze its characteristics,and to explore its mechanism.Methods A total of 5363 CTA images of head and neck were selected and analyzed,and 9 patients with acute internal carotid artery occlusion with ipsilateral carotid web were screened and their CTA images were analyzed,and the position,thickness,length of webs,contrast filling morphology of internal carotid artery occlusion stump,and changes in contrast medium concentration of occlusion stump were observed.Results Among the 9 patients with acute internal carotid artery occlusion with carotid webs,8 cases had unilateral webs with ipsilateral acute internal carotid artery occlusion,and 1 case had bilateral carotid webs with bilateral acute internal carotid artery occlusion.All carotid webs were located at the carotid bifurcation,and the thickness of the webs ranged from 1.2 to 3.3 mm,with an average thickness of(1.96±0.64)mm.The length range was from 4.5 to 18.9 mm,with an average length of(11.37±4.62)mm.In 9 cases of acute internal carotid artery occlusion,the contrast agent filling morphology was pointed upwards in the shape of a pointed stump,and the change of contrast medium concentration gradually faded towards the distal end.Conclusions CTA examina-tion of the head and neck in the early stage of stroke in patients with carotid webs and acute internal carotid artery occlusion can clearly show the characteristic manifestations of the acute occlusion site and the gradual fading of the contrast medium to the dis-tal end,which is helpful for neurointerventional physicians to carry out active clinical treatment.