ReviewStroke and vascular neurology2018
How to identify which patients with asymptomatic carotid stenosis could benefit from endarterectomy or stenting.
Review in Stroke and vascular neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 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
26 citing papers in PubMed, 68 citations in OpenAlex.
- Diagnosis of extracranial carotid stenosis by MRA of the brain.Scientific reports · 2021Trial
- Modern Management of Asymptomatic Carotid Stenosis: A Meta-Analysis of CREST-2, SPACE-2, and ECST-2.Annals of clinical and translational neurology · 2026Article
- Risk Prediction of Cerebrovascular Ischemic Events Following Cervical Artery Dissections Using High-Intensity Transient Signals: A Systematic Review, Meta-Analysis and a single center experience.Stroke (Hoboken, N.J.) · 2025Article
- Use of optical coherence tomography in selected patients with recurrent cryptogenic stroke: A case series and technical discussion.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Peri-Carotid Adipose Tissue and Atherosclerosis at Carotid Bifurcation.Journal of cardiovascular development and disease · 2024Article
- Article
- Quantifying Carotid Stenosis: History, Current Applications, Limitations, and Potential: How Imaging Is Changing the Scenario.Life (Basel, Switzerland) · 2024Review
- Article
- Comprehensive analysis of autophagy-related gene expression profiles identified five gene biomarkers associated with immune infiltration and advanced plaques in carotid atherosclerosis.Orphanet journal of rare diseases · 2023Article
- Increased Regional Market Competition is Associated with a Lower Threshold for Revascularization in Asymptomatic Carotid Artery Stenosis.Annals of vascular surgery · 2022Article
- Patient-Tailored Stenting versus Endarterectomy for the Treatment of Asymptomatic Carotid Artery Stenosis.Journal of personalized medicine · 2022Review
- Comparison of Doppler Ultrasound and Digital Subtraction Angiography in extracranial stenosis.Annals of medicine and surgery (2012) · 2022Article
- Hypothesis of "stroke-stop" formula: a tool for risk index determination in development of acute cerebrovascular disease in asymptomatic individuals with carotid stenosis.BMC neurology · 2021Article
- Non-stenotic Carotid Plaques in Embolic Stroke of Unknown Source.Frontiers in neurology · 2021Review
- Management of asymptomatic carotid stenosis.Annals of translational medicine · 2020Review
- Inflammation of carotid plaques and risk of cerebrovascular events.Annals of translational medicine · 2020Review
- The management of carotid restenosis: a comprehensive review.Annals of translational medicine · 2020Review
- Personalized-medicine on carotid endarterectomy and stenting.Annals of translational medicine · 2020Review
- Prevention and treatment of strokes associated with carotid artery stenosis: a research priority.Annals of translational medicine · 2020Article
- Uses of ultrasound in stroke prevention.Cardiovascular diagnosis and therapy · 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
3 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Offering routine carotid endarterectomy (CEA) or carotid artery stenting (CAS) to patients with asymptomatic carotid artery stenosis (ACS) is no longer considered as the optimal management of these patients. Equally suboptimal, however, is the policy of offering only best medical treatment (BMT) to all patients with ACS and not considering any of them for prophylactic CEA. In the last few years, there have been many studies aiming to identify reliable predictors of future cerebrovascular events that would allow the identification of patients with high-risk ACS and offer a prophylactic carotid intervention only to these patients to prevent them from becoming symptomatic. All patients with ACS should receive BMT. The present article will summarise the evidence suggesting ways to identify these high-risk asymptomatic individuals, namely: (1) microemboli detection on transcranial Doppler, (2) plaque echolucency on Duplex ultrasound, (3) progression in the severity of ACS, (4) silent embolic infarcts on brain CT/MRI, (5) reduced cerebrovascular reserve, (6) increased size of juxtaluminal hypoechoic area, (7) identification of intraplaque haemorrhage using MRI and (8) carotid ulceration. The evidence suggests that approximately 10%-15% of patents with asymptomatic stenosis might benefit from intervention; this will become more clear after publication of ongoing studies comparing stenting or endarterectomy with best medical therapy. In the meantime, no patient should be offered intervention unless there is evidence of high risk of ipsilateral stroke, from modalities such as those discussed here.
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.