SynthesisJournal of vascular surgery2024
Recent advances and controversial issues in the optimal management of asymptomatic carotid stenosis.
Synthesis in Journal of vascular surgery, 2024. 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.
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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.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Transcarotid Artery Revascularization for Asymptomatic Carotid Stenosis: A Systematic Review and Meta-Analysis.Translational stroke research · 2026Pooled it
- Carotid artery stenosis: a guide for clinicians.Future cardiology · 2026Review
- Assessing the Functional Severity of Carotid Artery Stenosis Using an Image-Based Hemodynamic Modeling Method.Annals of biomedical engineering · 2026Article
- Interpretable machine learning analysis of routine blood biomarkers and derived indicators for predicting coronary heart disease in patients with carotid stenosis.BMC cardiovascular disorders · 2026Article
- Reconsidering Carotid Artery Stenting for Asymptomatic Carotid Stenosis in the Era of Endovascular Evolution.Biomedicines · 2026Article
- Free water in white matter links focal hemodynamic compromise to cognitive impairment in asymptomatic extracranial carotid artery stenosis.BMC medical imaging · 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
- Radiomics-based diagnosis of carotid artery stenosis using non-contrast CT: model development and validation.European journal of medical research · 2025Article
- Hemodynamics in carotid artery stenosis.International angiology : a journal of the International Union of Angiology · 2025Review
- Carotid Plaque-Derived Small Extracellular Vesicles Mediate Atherosclerosis and Correlate With Plaque Vulnerability.MedComm · 2025Article
- Contemporary carotid artery stenting practices and peri-procedural outcomes in different European countries: ROADSAVER study multicentric insights.CVIR endovascular · 2025Article
- Review
- Review
- O-GlcNAcylation-dependent liquid-liquid phase separation regulates the nuclear translocation of YAP to exacerbate vascular neointimal hyperplasia.Theranostics · 2025Article
- Impact of carotid artery revascularization on cognitive function: a study of symptomatic and asymptomatic cases.Frontiers in neurology · 2025Article
- One year outcomes following of carotid endarterectomy in different age groups: Russian multicenter study.Indian journal of thoracic and cardiovascular surgery · 2024Article
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
objectiveThe optimal management of patients with asymptomatic carotid stenosis (AsxCS) is enduringly controversial. We updated our 2021 Expert Review and Position Statement, focusing on recent advances in the diagnosis and management of patients with AsxCS.
methodsA systematic review of the literature was performed up to August 1, 2023, using PubMed/PubMed Central, EMBASE and Scopus. The following keywords were used in various combinations: "asymptomatic carotid stenosis," "carotid endarterectomy" (CEA), "carotid artery stenting" (CAS), and "transcarotid artery revascularization" (TCAR). Areas covered included (i) improvements in best medical treatment (BMT) for patients with AsxCS and declining stroke risk, (ii) technological advances in surgical/endovascular skills/techniques and outcomes, (iii) risk factors, clinical/imaging characteristics and risk prediction models for the identification of high-risk AsxCS patient subgroups, and (iv) the association between cognitive dysfunction and AsxCS.
resultsBMT is essential for all patients with AsxCS, regardless of whether they will eventually be offered CEA, CAS, or TCAR. Specific patient subgroups at high risk for stroke despite BMT should be considered for a carotid revascularization procedure. These patients include those with severe (≥80%) AsxCS, transcranial Doppler-detected microemboli, plaque echolucency on Duplex ultrasound examination, silent infarcts on brain computed tomography or magnetic resonance angiography scans, decreased cerebrovascular reserve, increased size of juxtaluminal hypoechoic area, AsxCS progression, carotid plaque ulceration, and intraplaque hemorrhage. Treatment of patients with AsxCS should be individualized, taking into consideration individual patient preferences and needs, clinical and imaging characteristics, and cultural, ethnic, and social factors. Solid evidence supporting or refuting an association between AsxCS and cognitive dysfunction is lacking.
conclusionsThe optimal management of patients with AsxCS should include BMT for all individuals and a prophylactic carotid revascularization procedure (CEA, CAS, or TCAR) for some asymptomatic patient subgroups, additionally taking into consideration individual patient needs and preference, clinical and imaging characteristics, social and cultural factors, and the available stroke risk prediction models. Future studies should investigate the association between AsxCS with cognitive function and the role of carotid revascularization procedures in the progression or reversal of cognitive dysfunction.
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