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High-risk carotid plaque features may be more accurate predictors of ipsilateral ischemic stroke risk than the degree of carotid artery stenosis

Introduction: The optimal management of patients with asymptomatic carotid stenosis (AsxCS) is enduringly controversial. The current stratification of AsxCS patients based on the degree of stenosis alone does not always reflect ipsilateral ischemic stroke risk. We hypothesized that the presence of ≥...

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Autores principales: Paraskevas, Kosmas I. (Autor) , Saba, Luca (Autor) , Perler, Bruce A. (Autor) , Aburahma, Ali (Autor) , Sultan, Sherif (Autor) , Meschia, James F. (Autor) , Lal, Brajesh K. (Autor) , Lyden, Sean P. (Autor) , Malas, Mahmoud B. (Autor) , Erben, Young M. (Autor) , Mansilha, Armando (Autor) , Gargiuilo, Mauro (Autor) , Faggioli, Gianluca (Autor) , Pini, Rodolfo (Autor) , White, Christopher J. (Autor) , Abularrage, Christopher J. (Autor) , Spinelli, Francesco (Autor) , Blecha, Matthew (Autor) , Dardik, Alan (Autor) , Myrcha, Piotr (Autor) , Lanza, Gaetano (Autor) , Spinetti, Gaia (Autor) , Menyhei, Gabor (Autor) , Bruno, Antonino (Autor) , Ringleb, Peter A. (Autor) , Reiff, Tilman (Autor) , Stilo, Francesco (Autor) , Mikhailidis, Dimitri P. (Autor) , Gray, William A. (Autor) , Jawien, Arkadiusz (Autor) , D’oria, Mario (Autor) , Svetlikov, Alexei (Autor) , Silvestrini, Mauro (Autor) , Poredos, Pavel (Autor) , Fernandes E Fernandes, Jose (Autor) , Di Lazzaro, Vincenzo (Autor) , Eldrup-Jorgensen, Jens (Autor) , Gurevich, Victor (Autor) , Liapis, Christos D. (Autor) , Stone, David H. (Autor) , Schneider, Peter A. (Autor) , Gallitto, Enrico (Autor) , Dermody, Meghan (Autor) , Vacirca, Andrea (Autor) , Sawicka, Agnieszka (Autor) , Sufali, Gemmi (Autor) , Mackevicius, Arturas (Autor) , Baltrunas, Tomas (Autor) , Kashyap, Vikram S. (Autor) , Zeebregts, Johannes Adrianus Maria (Autor) , Musialek, Piotr (Autor) , Setacci, Carlo (Autor) , Schermerhorn, Marc L. (Autor) , Lip, Gregory Y. (Autor) , Nicolaides, Andrew N. (Autor) , Chaturvedi, Seemant (Autor)
Formato: Article (Journal)
Lenguaje:inglés
Publicado: 2025 June
In: International angiology
Year: 2025, Volumen: 44, Número: 3, Pages: 224-234
ISSN:1827-1839
DOI:10.23736/S0392-9590.25.05431-8
Acceso en línea:Resolving-System, kostenfrei, Volltext: https://doi.org/10.23736/S0392-9590.25.05431-8
Verlag, kostenfrei, Volltext: https://www.minervamedica.it/en/journals/international-angiology/article.php?cod=R34Y2025N03A0224
Enlace del recurso
Notas de Autor:Kosmas I. Paraskevas, Luca Saba, Bruce A. Perler, Ali Aburahma, Sherif Sultan, James F. Meschia, Brajesh K. Lal, Sean P. Lyden, Mahmoud B. Malas, Young M. Erben, Armando Mansilha, Mauro Gargiuilo, Gianluca Faggioli, Rodolfo Pini, Christopher J. White, Christopher J. Abularrage, Francesco Spinelli, Matthew Blecha, Alan Dardik, Piotr Myrcha, Gaetano Lanza, Gaia Spinetti, Gabor Menyhei, Antonino Bruno, Peter Arthur Ringleb, Tilman Reiff, Francesco Stilo, Dimitri P. Mikhailidis, William A. Gray, Arkadiusz Jawien, Mario D’Oria, Alexei Svetlikov, Mauro Silvestrini, Pavel Poredos, Jose Fernandes E Fernandes, Vincenzo Di Lazzaro, Jens Eldrup-Jorgensen, Victor Gurevich, Christos D. Liapis, David H. Stone, Peter A. Schneider, Enrico Gallitto, Meghan Dermody, Andrea Vacirca, Agnieszka Sawicka, Gemmi Sufali, Arturas Mackevicius, Tomas Baltrunas, Vikram S. Kashyap, Clark J. Zeebregts, Piotr Musialek, Carlo Setacci, Marc L. Schermerhorn, Gregory Y. Lip, Andrew N. Nicolaides, Seemant Chaturvedi
Descripción
Sumario:Introduction: The optimal management of patients with asymptomatic carotid stenosis (AsxCS) is enduringly controversial. The current stratification of AsxCS patients based on the degree of stenosis alone does not always reflect ipsilateral ischemic stroke risk. We hypothesized that the presence of ≥1 “high-risk” carotid plaque feature may more accurately identify AsxCS patients at high risk for a future ipsilateral ischemic cerebrovascular event. Evidence acquisition: We reviewed the literature for evidence supporting an association between high-risk carotid plaque features with ipsilateral ischemic stroke risk. Evidence synthesis: Certain carotid plaque features, such as intraplaque hemorrhage, lipid-rich necrotic core, thinning/rupture of the fibrous cap, ulceration, or neovascularization, may more accurately stratify patients at low vs. high future stroke risk. The presence of ≥1 “high-risk” carotid plaque characteristics can inform decisions on the conservative vs. invasive management of AsxCS patients and target carotid revascularization procedures to those AsxCS patient subgroups at high stroke risk who are more likely to benefit from them. Conclusions: The present article presents the rationale supporting stratification of AsxCS patients not based on the degree of stenosis, but on the presence of one or more specific high-risk plaque features that increase the risk of a future ipsilateral ischemic cerebrovascular event.
Notas:Gesehen am 29.05.2026
Descripción Física:Online Resource
ISSN:1827-1839
DOI:10.23736/S0392-9590.25.05431-8

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