Evidence map›Paper›PMID 39851043›Full record

Observational studyStroke2025

Prevalence of High-Risk CTA-Based Carotid Plaque-RADS Subtypes in Patients With Embolic Stroke of Undetermined Source.

Jae W Song, Huy Q Phi, Manisha Koneru, Quy Cao, Jeremy Rubin, Yu Sakai, Lamya Ibrahim, Sonya E Zhou, John H Woo, Scott E Kasner and 2 more

Abstract readObservational Study
In one paragraph

Observational study in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Thrombus composition identifies distinct etiologic phenotypes in embolic stroke of undetermined source.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Clinical implications of vessel wall imaging-State-of-the-art review.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
    Review
  10. Association of Carotid Plaque Calcification Attenuation With Intraplaque Hemorrhage Volume: 3D-Segmentation Analysis.Journal of neuroimaging : official journal of the American Society of Neuroimaging
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jae W SongDepartments of Radiology (J.W.S., Y.S., J.H.W.), University of Pennsylvania, PA.ORCID 0000-0002-3127-6427
Huy Q PhiDrexel University College of Medicine, Philadelphia, PA (H.Q.P.).ORCID 0000-0003-3705-9850
Manisha KoneruCooper Medical School of Rowan University, Camden, NJ (M.K.).ORCID 0000-0001-5012-6793
Quy CaoBiostatistics (Q.C., J.R.), University of Pennsylvania, PA.ORCID 0000-0002-6204-1305
Jeremy RubinBiostatistics (Q.C., J.R.), University of Pennsylvania, PA.ORCID 0000-0002-8288-6022
Yu SakaiDepartments of Radiology (J.W.S., Y.S., J.H.W.), University of Pennsylvania, PA.ORCID 0009-0002-0217-1631
Lamya IbrahimNeurology (L.I., S.E.Z., S.E.K., B.L.C.), University of Pennsylvania, PA.ORCID 0009-0005-0231-8375
Sonya E ZhouNeurology (L.I., S.E.Z., S.E.K., B.L.C.), University of Pennsylvania, PA.ORCID 0000-0002-3695-5613
John H WooDepartments of Radiology (J.W.S., Y.S., J.H.W.), University of Pennsylvania, PA.ORCID 0000-0002-5405-8537
Scott E KasnerNeurology (L.I., S.E.Z., S.E.K., B.L.C.), University of Pennsylvania, PA.ORCID 0000-0003-0418-6917
Luca SabaDepartment of Radiology, University of Cagliari, Italy (L.S.).ORCID 0000-0003-2870-3771
Brett L CucchiaraNeurology (L.I., S.E.Z., S.E.K., B.L.C.), University of Pennsylvania, PA.ORCID 0000-0002-5218-9015

Funding

American Heart Association-American Stroke Association 938082
6 · The paper itself

Abstract

backgroundA modified computed tomography angiography (CTA)-based Carotid Plaque Reporting and Data System (Plaque-RADS) classification was applied to a cohort of patients with embolic stroke of undetermined source to test whether high-risk Plaque-RADS subtypes are more prevalent on the ipsilateral side of stroke. With the widespread use of CTA for stroke evaluation, a CTA-based Plaque-RADS would be valuable for generalizability.

methodsA retrospective observational cross-sectional study was conducted at a single integrated health system comprised of 3 hospitals with a comprehensive stroke center between October 1, 2015, and April 1, 2017. Patients with unilateral anterior circulation stroke and <50% carotid stenosis on CTA were retrospectively identified. Maximum plaque thickness and ulceration were assessed by a neuroradiologist blinded to the stroke side. A semiautomated segmentation software measured intraplaque hemorrhage volumes. Modified CTA-based Plaque-RADS classification was defined as (1) no plaque, (2) plaque thickness <3 mm, (3) plaque thickness ≥3 mm or ulcerated, and (4) plaque with intraplaque hemorrhage >50 mm

resultsNinety-four patients (55% women; median age, 66 years) were included. CTA-based Plaque-RADS categories for plaques ipsilateral to the stroke side were as follows: (1) 14.9%, (2) 42.6%, (3) 41.5%, and (4) 1.1%. Carotid plaques contralateral to stroke side were Plaque-RADS: (1) 21.3%, (2) 46.8%, (3) 31.9%, and (4) 0%. When compared with the contralateral side, plaques ipsilateral to the stroke side were significantly associated with high-risk Plaque-RADS subtypes in a mixed-effects logistic model adjusting for age and sex (adjusted odds ratio, 2.10 [95% CI, 1.20-3.71];

conclusionsCarotid plaque ipsilateral to the stroke side was significantly associated with CTA-based high-risk Plaque-RADS subtypes in an embolic stroke of undetermined source cohort. A CTA-based Plaque-RADS classification may be useful for identifying potentially causative carotid plaque phenotypes in patients with embolic stroke of undetermined source.

Indexed as

Carotid StenosisComputed Tomography AngiographyEmbolic StrokePlaque, AtheroscleroticAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMiddle AgedPrevalenceRetrospective Studiesatherosclerosiscarotid stenosisembolic strokehemorrhagehospitalsstroke

Identifiers

PMID39851043
PMCPMC11898214

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.