ReviewFrontiers in neurology
Controversies in the management of asymptomatic carotid stenosis: from best medical therapy to a redefinition of surgical indications.
Review in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Asymptomatic carotid artery stenosis has become increasingly detected with population aging and the widespread use of high-resolution vascular imaging. Its management is undergoing a transition from stenosis-based anatomical assessment toward multidimensional biological risk stratification. The relative benefit of prophylactic carotid revascularization, including carotid endarterectomy and carotid artery stenting, versus best medical therapy remains controversial. In recent years, best medical therapy has evolved substantially with intensive lipid-lowering strategies, PCSK9 inhibitors, novel glucose-lowering agents, and improved control of vascular risk factors, thereby reshaping the expected benefit of preventive intervention. Meanwhile, recent randomized trials, including ACST-2, ECST-2, and CREST-2, have challenged the traditional reliance on luminal stenosis as the dominant criterion for intervention. This review summarizes key evidence from 2021 to 2026 regarding contemporary medical therapy, revascularization trials, and emerging approaches to risk assessment in asymptomatic carotid stenosis. It discusses the clinical value of high-resolution magnetic resonance imaging, cerebrovascular hemodynamic reserve, and exosomal microRNAs for identifying vulnerable plaques and biologically high-risk disease. It also reconsiders the definition of "asymptomatic" by incorporating covert cognitive impairment and findings from CREST-H. Finally, this review proposes an individualized precision-management framework based on multimodal biomarkers.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.