What question did this study set out to answer?

This research aims to evaluate the role of nonstenotic carotid plaques in embolic stroke of undetermined source using CTA-based Plaque-RADS.

March 21, 2026

CTA-Based Plaque-RADS to Assess Etiologic Role of Nonstenotic Carotid Plaques in Patients With Embolic Stroke of Undetermined Source

Key Points

This research aims to evaluate the role of nonstenotic carotid plaques in embolic stroke of undetermined source using CTA-based Plaque-RADS.
Applied CTA-based Plaque-RADS to categorize nonstenotic carotid plaques (NSCPs).
Analyzed the association between ipsilateral high-risk NSCPs and index stroke side.
Evaluated prevalence of competing cardioembolic sources.
Identified a strong association between high-risk NSCPs and the index stroke side.
Observed a lower prevalence of other cardioembolic sources in patients with high-risk NSCPs.
Confirmed an increased rate of ipsilateral stroke recurrence linked to high-risk NSCPs.

Abstract

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.

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Discussion

Authors

Angelo Cascio Rizzo

Ghil Schwarz

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

Simone Bellavia

Università Cattolica del Sacro Cuore

Journals

Neurology

Actions

Institutions

University of Milano-Bicocca

Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda

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CTA-Based Plaque-RADS to Assess Etiologic Role of Nonstenotic Carotid Plaques in Patients With Embolic Stroke of Undetermined Source

Key Points

Abstract

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Discussion

Authors

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