Key result
Carotid stenting resolves recurrent embolic strokes caused by focal flow stasis in ulcerated plaque.
Why the study?
Non-stenotic carotid atheromatous disease and carotid webs are increasingly recognised aetiologies of ischaemic stroke, and this report presents a potential novel stroke mechanism from non-stenotic carotid atheromatous disease.
Case Report (n=1)
Flow stasis within an ulcerated carotid plaque may represent a previously unrecognized, stenting-responsive mechanism of embolic stroke in non-stenotic carotid atherosclerosis.
Answers are grounded in this paper and cite their sources.
May represent stenting-responsive mechanism in non-stenotic carotid ulcers; hypothesis-generating and requires prospective validation before practice change.
BACKGROUND Non-stenotic carotid atheromatous disease (SyNC) and carotid webs (CaW) are increasingly recognised aetiologies of ischaemic stroke. We present a potential novel stroke mechanism from non-stenotic carotid atheromatous disease. CASE PRESENTATION We report a 77-year-old patient with recurrent internal carotid artery-territory embolic strokes over a decade in the context of a non-stenotic, chronically ulcerated left internal carotid artery atherosclerotic plaque. Focal stasis within the ulcerated plaque was the probable mechanism, analogous to carotid web. CONCLUSION Stasis of flow within plaque ulceration may be a previously unrecognised stenting-responsive stroke mechanism, in both stenotic and non-stenotic carotid atherosclerosis.
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Lines et al. (2026) conducted a case report in Recurrent internal carotid artery-territory embolic strokes with non-stenotic, chronically ulcerated left internal carotid artery atherosclerotic plaque (n=1). Focal stasis within ulcerated carotid plaque (stenting-responsive) was evaluated on Recurrent internal carotid artery-territory embolic strokes. Focal flow stasis within a non-stenotic, chronically ulcerated left internal carotid artery plaque was identified as a probable, stenting-responsive mechanism for recurrent embolic strokes in a 77-year-old patient.
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