Contralateral Stenosis and Echolucent Plaque Morphology are Associated with Elevated Stroke Risk in Patients Treated with Asymptomatic Carotid Artery Stenosis within a Controlled Clinical Trial (SPACE-2)

Carotid Endarterectomy Versus Stenting for the Treatment of Patients With Carotid Artery Stenosis: An Updated Systematic Review and Meta-Analysis

“…Reiff et al (2021) note that the risk of patients getting a stroke was correlated to having severe stenosis of the carotid artery as well as having an occlusion [13]. Cerebrovascular events in the study were reported as being affected by the degree of contralateral stenosis.…”

“…Stroke: Ten studies were used in this outcome analysis [13,[15][16][17][18][19][20][21][22][23]. A total of 16,546 patients were included in the analysis on stroke, randomized as 7419 patients in endarterectomy treatment and 9127 in the stenting treatment.…”

“…In addition, the test has a heterogeneity of df = 2 (P = 0.32) and I2 = 11%. Figures 12,13 below are the forest and funnel plots from the meta-analysis.…”

“…Studies[13][14][15][16][17][18][19][20][21][22][23].QVSS: Questionnaire for Verifying Stroke-Free Status.…”

Ultrasound assessment of brain supplying arteries (extracranial)

“…This includes a plaque area > 40 mm 2 determined by duplex ultrasound, a highly echo-deficient structure of the plaque, evidence of juxtaluminal hypoechogenic areas > 4 mm 2 , and plaque perfusion detected by echo signal amplifiers as a surrogate for neovascularization [12,14,23]. Hypoechogenic plaque and contralateral stenosis or occlusion of the ICA were also associated with an increased cerebrovascular event rate in the multicenter SPACE-2 trial [24]. Other embolic factors include hemorrhage into the plaque or plaque volume detectable by MRI [25], detection of microembolism signals in transcranial Doppler/duplex ultrasound (EJU-12-2022-4213-CE.R1, accepted for publication), and limited cerebrovascular reserve capacity [13,26].…”