CTA-based Plaque-RADS can be reliably applied in routine clinical practice to categorize NSCPs in ESUS. Ipsilateral high-risk NSCPs are strongly associated with the index stroke side, lower prevalence of competing cardioembolic sources, and increased ipsilateral recurrence, supporting their role as a distinct causal mechanism within ESUS and underscoring the need for randomized trials on secondary prevention.
Rizzo et al. (Tue,) studied this question.