ArticleEuropean radiology2020
Carotid near-occlusion is often overlooked when CT angiography is assessed in routine practice.
Article in European radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Carotid near-occlusion diagnostics and its consequences: A systematic review.European stroke journal · 2026Pooled it
- Short-term risk of recurrent stroke in symptomatic carotid near-occlusion: pooled analysis of three cohort studies.European stroke journal · 2026Article
- Carotid near-occlusion diagnostics and its consequences: A systematic review.European stroke journal · 2025Review
- Rule-out and rule-in of carotid near-occlusion using color duplex ultrasound.Neuroradiology · 2025Article
- The pitfalls and challenges in the diagnosis and treatment of patients with carotid near-occlusion: a narrative review.Quantitative imaging in medicine and surgery · 2024Review
- Assessments of arterial and venous phase radiodensity does not improve carotid near-occlusion diagnostics.Scientific reports · 2024Article
- Phase-contrast magnetic resonance imaging of intracranial and extracranial blood flow in carotid near-occlusion.Neuroradiology · 2024Article
- Diagnostic separation of conventional ⩾50% carotid stenosis and near-occlusion with phase-contrast MRI.European stroke journal · 2024Article
- Quantifying Carotid Stenosis: History, Current Applications, Limitations, and Potential: How Imaging Is Changing the Scenario.Life (Basel, Switzerland) · 2024Review
- Diagnosis of Ischemic Stroke: As Simple as Possible.Diagnostics (Basel, Switzerland) · 2022Review
- Variability of acquisition phase of computed tomography angiography in acute ischemic stroke in a real-world scenario.European radiology · 2022Article
- Defining carotid near-occlusion with full collapse: a pooled analysis.Neuroradiology · 2022Article
- The periprocedural and 30-day outcomes of carotid stenting in patients with carotid artery near-occlusion.Scientific reports · 2021Article
- Diagnosing Carotid Near-Occlusion with Phase-Contrast MRI.AJNR. American journal of neuroradiology · 2021Article
- Cerebral Small Vessel Disease Burden Related to Carotid Intraplaque Hemorrhage Serves as an Imaging Marker for Clinical Symptoms in Carotid Stenosis.Frontiers in neurology · 2021Article
- Pre-operative Cerebral Small Vessel Disease on MR Imaging Is Associated With Cerebral Hyperperfusion After Carotid Endarterectomy.Frontiers in cardiovascular medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveAssess the sensitivity and specificity of computed tomography angiography (CTA) for carotid near-occlusion diagnosis interpreted in clinical practice against expert assessment.
methodsCTAs were graded by two expert interpreters for near-occlusion. Findings were compared with clinical reports in 383 consecutive cases with symptomatic ≥ 50% carotid stenosis. In addition, 14 selected CTA exams (8 near-occlusions and 6 controls) were analyzed in a national effort by 13 radiologists experienced with carotid CTA.
resultsIn clinical practice, imaging reports were 20% (95% CI 12-28%) sensitive for near-occlusion, ranging 0-58% between different radiologists; specificity was 99%. Among the 13 radiologists reviewing the same 8 near-occlusions, the average sensitivity was 8%, ranging 0-75%; specificity was 100%.
conclusionsCarotid near-occlusion is systematically under-reported in clinical routine practice, caused by limited application of grading criteria when assessing CTA. KEY POINTS: • Carotid near-occlusion is severe stenosis with distal artery collapse; this collapse is often subtle. • A fifth of near-occlusions were detected in routine practice. Many readers mistake near-occlusion for stenosis without distal artery collapse, either by not actively searching for subtle collapses or by not interpreting the collapse correctly when noticed. • On the other hand, the novice diagnostician should be cautioned to not over-diagnose near-occlusion; other causes of extracranial ICA asymmetry also exist such as distal disease and Circle of Willis anatomical variants.
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.