Clinical Utility of 3D-TOF MRA and CTA in Predicting Short-Term Prognosis After Endovascular Treatment for Carotid Web–Related Ischemic Stroke

Objective To investigate the relationship between imaging characteristics derived from three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA) and multiphase computed tomography angiography (CTA), and short-term outcomes following endovascular treatment in patients with ischemic stroke associated with carotid web (CaW). Methods This retrospective study analyzed clinical and imaging data of 157 ischemic stroke patients with confirmed CaW who underwent endovascular treatment. Based on the modified Rankin Scale (mRS) score at 3-month follow-up, patients were divided into a good outcome group (n = 78) and a poor outcome group (n = 20). Clinical and imaging parameters were compared between the two groups. Multivariate logistic regression analysis was performed to identify independent predictors of poor short-term outcomes. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive value of 3D-TOF MRA and CTA scores. Results Multivariate logistic regression identified age, hypertension, hyperlipidemia, stroke severity, ICU admission, infarct size, 3D-TOF MRA score, and CTA score as independent predictors of poor short-term outcome (P < 0.05). ROC analysis demonstrated good predictive performance, with areas under the curve (AUC) of 0.877 for the 3D-TOF MRA score, 0.892 for the CTA score, and 0.926 for the combined model. Conclusion Imaging characteristics from 3D-TOF MRA and CTA are valuable predictors of short-term outcomes after endovascular treatment in ischemic stroke patients with CaW, and may serve as important references for clinical decision-making.