Carotid webs don’t cause stroke because of stenosis. The narrowing is minimal.The problem is flow.In this video, I walk through a DSA of a carotid web. You’ll see contrast accelerate over the web and then pool behind it. That pocket of stasis is exactly where clot forms.Stasis alone satisfies Virchow’s triad. But stasis also kills shear stress, and the endothelial glycocalyx depends on shear to stay intact. When it thins, you lose its natural anti-clot functions, platelet inhibition, antithrombi
1:49
Carotid webs don’t cause stroke because of stenosis. The narrowing is minimal.The problem is flow.In this video, I walk through a DSA of a carotid web. You’ll see contrast accelerate over the web and then pool behind it. That pocket of stasis is exactly where clot forms.Stasis alone satisfies Virchow’s triad. But stasis also kills shear stress, and the endothelial glycocalyx depends on shear to stay intact. When it thins, you lose its natural anti-clot functions, platelet inhibition, antithrombi
8.6K views2 weeks ago
x.comWhitfield Lewis, MD 🇦🇬🇺🇸
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