Table.

Carotid Web Survey Responses by Subspecialty and Overall

Type of Respondent
Survey Question/ResponseGeneral NeurologistVascular NeurologistNeuroradiologistNeurointerventionalistAll
1. In what capacity do you practice? (select all that apply)
General neurologist6 (8)
Vascular neurologist11 (15)
Neuroradiologist10 (14)
Neurointerventionalist47 (64)
2. How familiar are you with this disease entity?
Never heard of it1 (17)1 (9)0 (0)3 (7)5 (7)
Limited clinical practice5 (83)4 (36)6 (60)17 (38)32 (44)
Routine clinical practice0 (0)5 (45)4 (40)24 (53)33 (46)
Extensive clinical practice0 (0)1 (9)0 (0)1 (2)2 (3)
3. How frequently do you encounter carotid webs?
Never5 (83)3 (27)1 (10)7 (15)16 (22)
1-2 cases per year1 (17)2 (18)5 (50)21 (45)29 (39)
3-5 cases per year0 (0)2 (18)2 (20)13 (28)17 (23)
6-10 cases per year0 (0)4 (36)2 (20)3 (6)9 (12)
>10 cases per year0 (0)0 (0)0 (0)3 (6)3 (4)
4. What imaging modality most commonly put carotid web in the differential diagnosis (even if further imaging was sought)?
(select all that apply)
Conventional DSA0 (0)4 (31)2 (13)15 (23)21 (21)
CTA3 (43)8 (62)10 (63)37 (57)58 (57)
MRA contrast enhanced1 (14)0 (0)2 (13)7 (11)10 (10)
MRA time of flight0 (0)0 (0)1 (6)2 (3)3 (3)
MRI vessel wall imaging0 (0)0 (0)1 (6)1 (2)2 (2)
Ultrasound Doppler0 (0)0 (0)0 (0)3 (5)3 (3)
Other (please specify)a3 (43)1 (8)0 (0)0 (0)4 (4)
5. Which imaging modalities do you prefer to confirm the diagnosis of carotid web? (select all that apply)
Conventional DSA1 (13)9 (69)4 (36)36 (59)50 (54)
CTA2 (25)2 (15)6 (55)13 (21)23 (25)
MRA contrast enhanced2 (25)2 (15)1 (9)5 (8)10 (11)
MRA time of flight0 (0)0 (0)0 (0)0 (0)0 (0)
MRI vessel wall imaging0 (0)0 (0)0 (0)3 (5)3 (3)
Ultrasound Doppler0 (0)0 (0)0 (0)3 (5)3 (3)
Other (please specify)a3 (38)0 (0)0 (0)1 (2)4 (4)
6. What is your preferred treatment of a carotid web in asymptomatic patients?
Don’t know4 (67)2 (18)3 (30)5 (11)14 (19)
Nothing0 (0)4 (36)1 (10)12 (26)17 (23)
Follow-up imaging only0 (0)0 (0)1 (10)1 (2)2 (3)
Aspirin only1 (17)3 (27)4 (40)21 (45)29 (39)
Plavix (clopidogrel) only0 (0)0 (0)0 (0)0 (0)0 (0)
Dual antiplatelet (aspirin/Plavix)1 (17)2 (18)1 (10)7 (15)11 (15)
Coumadin (warfarin)0 (0)0 (0)0 (0)0 (0)0 (0)
NOAC/DOAC0 (0)0 (0)0 (0)0 (0)0 (0)
Stent0 (0)0 (0)0 (0)0 (0)0 (0)
Endarterectomy0 (0)0 (0)0 (0)1 (2)1 (1)
7. What is your preferred treatment of a carotid web in the setting of acute (ischemic) stroke?
Don’t know4 (67)1 (9)3 (30)4 (9)12 (16)
Nothing0 (0)0 (0)0 (0)5 (11)5 (7)
Follow-up imaging only0 (0)0 (0)0 (0)0 (0)0 (0)
Aspirin only0 (0)5 (45)3 (30)11 (23)19 (26)
Plavix (clopidogrel) only0 (0)0 (0)0 (0)0 (0)0 (0)
Dual antiplatelet (aspirin/Plavix)1 (17)1 (9)3 (30)14 (30)19 (26)
Coumadin (warfarin)0 (0)1 (9)0 (0)0 (0)1 (1)
NOAC/DOAC0 (0)1 (9)0 (0)2 (4)3 (4)
Stent0 (0)0 (0)1 (10)9 (19)10 (14)
Endarterectomy1 (17)2 (18)0 (0)2 (4)5 (7)
8. What is your preferred treatment of a carotid web in the setting of multiple recurrent (ischemic) strokes?
Don’t know3 (50)3 (27)4 (40)4 (9)14 (19)
Nothing0 (0)0 (0)0 (0)2 (4)2 (3)
Follow-up imaging only0 (0)0 (0)0 (0)0 (0)0 (0)
Aspirin only0 (0)0 (0)0 (0)2 (4)2 (3)
Plavix (clopidogrel) only0 (0)0 (0)0 (0)0 (0)0 (0)
Dual antiplatelet (aspirin/Plavix)0 (0)0 (0)0 (0)5 (11)5 (7)
Coumadin (warfarin)0 (0)1 (9)0 (0)0 (0)1 (1)
NOAC/DOAC1 (17)0 (0)0 (0)1 (2)2 (3)
Stent1 (17)3 (27)3 (30)22 (47)29 (39)
Endarterectomy1 (17)4 (36)3 (30)11 (23)19 (26)
  • Notes: All data are reported as n (%). Questions 1, 4, and 5 allowed for multiple responses (“select all that apply”), reflected in the percentages in the All category.

  • aOther responses included “Have not personally encountered,” “Never heard of carotid web,” and “I do not ever decide on how to work up carotid webs.”

  • CTA, computed tomography angiography; DSA, digital subtraction angiography; MRA, magnetic resonance angiography; MRI, magnetic resonance imaging; NOAC/DOAC, novel oral anticoagulant/direct-acting anticoagulant.