Surgical Exploration and Endarterectomy for Symptomatic Carotid Web With Retained Thrombus

Abstract

Symptomatic carotid web with retained thrombus represents a potential source of embolic strokes. However, the absence of diagnostic guidelines contributes to heterogeneity in management recommendations. We present a patient with a right middle cerebral artery stroke attributable to carotid web with retained thrombus. Confirmation was obtained through surgical exploration, given the inconclusive imaging but strong index of suspicion. The presence of carotid web with retained thrombus was confirmed through surgical exploration. Cervical endarterectomy was performed and a carotid web with an associated thrombus was successfully resected. We highlight the importance of having a high index of suspicion and prompt treatment to mitigate the risk of recurrent strokes when suspecting carotid web with retained thrombus.