ReviewNature reviews. Cardiology2011
Time to rethink management strategies in asymptomatic carotid artery disease.
Review in Nature reviews. Cardiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 175 citations in OpenAlex.
- Carotid atherosclerotic plaque instability and cognition determined by ultrasound-measured plaque strain in asymptomatic patients with significant stenosis.Journal of neurosurgery · 2018Trial
- Trial
- Ultrasonographic markers of vascular risk in patients with asymptomatic carotid stenosis.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2013Trial
- Natural history of MRI-defined intraplaque hemorrhage-positive asymptomatic carotid stenosis in the contemporary medical era: a prospective multicenter cohort study.Neurosurgical review · 2026Article
- Modern Management of Asymptomatic Carotid Stenosis: A Meta-Analysis of CREST-2, SPACE-2, and ECST-2.Annals of clinical and translational neurology · 2026Article
- Evolving Trends in Carotid Endarterectomy and Stenting in Australia: A 15-Year Analysis in the Post-CREST Era.Vascular health and risk management · 2026Article
- Article
- The value of contrast-enhanced ultrasonography in predicting stroke occurrence: A prospective study.Heliyon · 2024Article
- William M. Feinberg Lecture: Asymptomatic Carotid Stenosis: Current and Future Considerations.Stroke · 2024Review
- MR Imaging of Carotid Artery Atherosclerosis: Updated Evidence on High-Risk Plaque Features and Emerging Trends.AJNR. American journal of neuroradiology · 2023Review
- Development of Molecular Magnetic Resonance Imaging Tools for Longitudinal Tracking of Carotid Atherosclerotic Disease Using Fast Imaging with Steady-State Precession.Translational stroke research · 2023Article
- Monocyte Phenotypes and Physical Activity in Patients with Carotid Atherosclerosis.Antioxidants (Basel, Switzerland) · 2022Article
- Article
- Impact of the first COVID-19 pandemic peak and lockdown on the interventional management of carotid artery stenosis in France.Journal of vascular surgery · 2022Article
- Article
- Extra-Cranial Carotid Artery Stenosis: An Objective Analysis of the Available Evidence.Frontiers in neurology · 2022Review
- Roadmap Consensus on Carotid Artery Plaque Imaging and Impact on Therapy Strategies and Guidelines: An International, Multispecialty, Expert Review and Position Statement.AJNR. American journal of neuroradiology · 2021Article
- Intraoperative completion studies in carotid endarterectomy: systematic review and meta-analysis of techniques and outcomes.Annals of translational medicine · 2021Article
- Management of Patients with Asymptomatic Carotid Stenosis May Need to Be Individualized: A Multidisciplinary Call for Action.Journal of stroke · 2021Review
- Carotid intraplaque haemorrhage: pathogenesis, histological classification, imaging methods and clinical value.Annals of translational medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite level I evidence, no worldwide consensus of opinion exists on how best to manage patients with asymptomatic carotid artery disease. In this article, I present the evidence supporting intervention in these patients, highlighting a number of 'inconvenient truths' that challenge the current 'one size fits all' approach to treatment. I will demonstrate that, even if one could identify and treat every individual with a 60-99% asymptomatic stenosis, >95% of all strokes will still occur. Evidence shows that 94% of all carotid endarterectomy and carotid artery stenting procedures in asymptomatic patients in the US are ultimately unnecessary, costing health-care providers US$2 billion annually. Evidence also exists that the risk of stroke in patients treated medically is lower than when the asymptomatic trials were recruiting, challenging the appropriateness of basing contemporary guidelines upon historical data. A small cohort of 'high-risk for stroke' patients will undoubtedly benefit from intervention and our goal must be to identify and treat these individuals, rather than continuing with a policy of mass intervention that benefits very few patients in the long term.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.