Montefiore Einstein remains at the forefront of understanding carotid webs, a rare, under-recognized cause of ischemic strokes. Co-led by Charles Esenwa, MD, Director of the Montefiore Einstein Comprehensive Stroke Center and Assistant Professor of Neurology, and Evan Lipsitz, Chief, Division of Vascular and Endovascular Surgery, our multidisciplinary team studied the largest hospital-based cohort of patients with strokes related to carotid webs in the nation to date. We analyzed nearly 6,000 participants and identified 82 individuals with this condition. Preliminary results suggest that participants with strokes related to a proven carotid web were significantly more likely to be younger women in their 40s and 50s, when compared to the rest of the cohort. 

This discovery not only increases awareness and advances our understanding of this condition but also emphasizes the need for targeted strategies for stroke prevention, diagnosis and treatment for this demographic.

At the Montefiore Einstein Comprehensive Stroke Center, our multidisciplinary team of stroke neurologists, vascular surgeons, neuroradiologists and pathologists continues to build on our research and experience in managing carotid webs to improve our understanding of this recently discovered stroke risk factor. We continue to investigate the pathogenesis of carotid webs, why they are predominantly seen in healthy younger women and how these web-like structures form in the carotid arteries (major blood vessels in the neck that supply blood to the brain) and cause ischemic strokes. 

Our team is at the forefront of the management of individuals with carotid webs, helping them live healthier lives without an added risk of stroke. A carotid web is a rare, under-recognized thin shelf-like abnormality in the carotid artery, characterized by a fibrous tissue growth and/or membrane-like formation that can cause narrowing of the artery or disruption of blood flow. This condition may increase the risk of an ischemic stroke by promoting the formation of blood clots that can travel to the brain, blocking critical blood vessels. Treatment for symptomatic carotid webs includes carotid revascularization with carotid endarterectomy and/or stenting.

In 2021, we also published the largest US epidemiologic study at the time to assess the prevalence of carotid webs. We found a carotid web prevalence of 1.6% in our urban, North American cohort. There was a high incidence of ipsilateral anterior circulation strokes, the majority of which were otherwise considered cryptogenic.

This study highlights our continued commitment to innovation in stroke care and improving outcomes for individuals who have had or are at risk for strokes. We’re ranked in the top 1% of all hospitals in the nation for neurology and neurosurgery according to U.S. News & World Report, and we are an international referral site for the most complex cases.