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March 29, 2026Journal of UltrasoundOpen Access

The paradox of asymptomatic carotid atherosclerosis in women: gender differences

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Why the study?

Women with stroke exhibit higher rates of death and disability despite a lower incidence than men, likely due to atypical symptoms causing delayed hospital arrival and diagnosis.

Population

Two patients (one female and one male) with asymptomatic carotid stenosis

Comparison

Female vs male patient

Design

Case series

Key result

Male and female patients with approximately 50% asymptomatic carotid stenosis exhibited distinct plaque characteristics, highlighting the need for personalized, sex-specific medical management.

Authors

AGAngela Di GiorgioBBBianca BiferaliMDMarco D’Angelo

Discussion

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Overview

May warrant sex-specific therapy in asymptomatic carotid stenosis; leaves open optimal strategies pending larger confirmatory studies.

Key Points

  • This research aims to explore gender differences in asymptomatic carotid atherosclerosis and their impact on stroke risk.
  • Presented clinical cases of a male and female patient with asymptomatic carotid stenosis.
  • Examined characteristics of atherosclerotic plaques and risk factors in both genders.
  • Highlighted the impact of delayed diagnosis on outcomes for women.
  • Women presented more atypical symptoms compared to men, affecting early diagnosis.
  • Gender differences in risk factors were evident in case presentations.
  • Initiation of medical therapy showed potential benefits in preventing complications.

Study Design

Type

Case Report (n=2)

Multicenter

No

Structured PICO

P
Population
A 50-year-old woman and a 64-year-old man with asymptomatic carotid stenosis
I
Intervention
Medical therapy optimization (statin, aspirin, antihypertensive, ezetimibe)

Gender differences in asymptomatic carotid atherosclerosis necessitate personalized assessment and medical therapy optimization.

Limitations

  • Case report design with only two patients limits generalizability
  • Lack of quantitative statistical analysis due to study design

Cite This Study

Giorgio et al. (2026) conducted a case report in Asymptomatic carotid atherosclerosis (n=2). Personalized medical therapy was evaluated. Male and female patients with approximately 50% asymptomatic carotid stenosis exhibited distinct plaque characteristics, highlighting the need for personalized, sex-specific medical management.

synapsesocial.com/papers/69c8c35cde0f0f753b39e15ahttps://doi.org/10.1007/s40477-026-01145-9
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