Platelet deposition can occur in the corrugations of carotid web, forming a nidus for potential blood flow stagna- tion and thromboembolism. Carotid web is a known cause of ischemic stroke in young patients <65 years of age; it is detected in up to 9.5% of patients <65 years of age with anterior circulation stroke of unknown Recommendation-Specific Supportive Text 1. The optimal management of symptomatic carotid web is unknown. Medical management with anti- thrombotic therapy is first-line treatment; how- ever, it is not known whether SAPT, short-term DAPT, or anticoagulant therapy is superior. In the absence of such data, it is recommended to treat patients with antiplatelet therapy first line or to follow antithrombotic recommendations in this guideline. 2. There is a high risk of recurrent stroke or TIA in patients with symptomatic carotid web on medi- cal management, estimated in 29% to 56% of Carotid stenting or CEA is a good alternative treatment for patients with symptom- atic carotid web, with published series revealing no recurrent stroke risk.748,749 Knowledge Gaps and Future Research The optimal medical or interventional management of symptomatic carotid web is unknown. Future prospec- tive research evaluating the natural history of symptom- atic carotid web on medical management compared with interventional management would be of interest and evolve to multicenter randomized trials comparing medical management (ie, antiplatelet versus anticoagu- lant, then best medical therapy versus carotid stenting or CEA) if enough patients can be identified. CLINICAL STATEMENTS AND GUIDELINES Kleindorfer 5.16. Fibromuscular Dysplasia Recommendations for Fibromuscular Dysplasia Referenced studies that support recommendations are summarized in online Data Supplement 54. 