SynthesisEuropean stroke journal2026
Carotid near-occlusion diagnostics and its consequences: A systematic review.
Synthesis in European stroke journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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
2 citing papers in PubMed.
- Risk of early stroke recurrence and procedural stroke or death in carotid near occlusion patients scheduled for carotid endarterectomy.Journal of neurology · 2026Article
- Short-term risk of recurrent stroke in symptomatic carotid near-occlusion: pooled analysis of three cohort studies.European stroke journal · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
introductionTo summarize carotid near-occlusion (CNO) diagnostics and its consequences on epidemiology and management. MATERIALS AND
methodsA systematic search of PubMed using 19 known synonyms for CNO was performed. Diagnostic analyses of CNO were assessed. Epidemiological and management analyses were based on how the CNO diagnostics was conducted, with diagnostics resembling large trials considered "good."
resultsCNO can be diagnosed with several modalities and approaches (interpretation or measurements). Interpretation of angiography is the reference standard but is not feasible for routine use. Of feasible methods, flow measurements with phase-contrast magnetic resonance imaging (PC-MRI) were considerably better than other alternatives when assessed blinded: 90%-100% sensitive and 99%-100% specific and inter-rater kappa 0.98-1.0. CNO was consistently common (30% of ⩾50% stenosis) in studies with "good" CNO diagnostics but was also often described as rare. Symptomatic CNO have no benefit with revascularization in studies with "good" CNO diagnostics, which foremost applies to the moderate subtype (without full collapse). The more severe CNO subtype (with full collapse) seems to have a very high risk of stroke within the first 2 days, but revascularization performed sufficiently early to prevent this has never been assessed. DISCUSSION: CNO diagnostics is difficult and that CNO is perceived as rare by many is likely due to poor diagnostics. Such poor diagnostics also likely result in unnecessary surgeries for many symptomatic CNOs.
conclusionCNO is a common variant of carotid stenosis. New diagnostic methods (especially PC-MRI) should be introduced, possibly after validation of its prognostic impact in a randomized trial.
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Registered trials
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