Carotid artery occlusion is a cerebrovascular disorder in which complete obstruction of the extracranial or intracranial carotid arterial lumen, usually after progressive carotid atherosclerosis, can reduce cerebral or retinal perfusion and increase risk for transient ischemic attack, ischemic stroke, and chronic hemodynamic compromise.
Ask a research question about Carotid Artery Occlusion. OpenScientist will conduct autonomous deep research using the Disorder Mechanisms Knowledge Base and PubMed literature (typically 10-30 minutes).
Do not include personal health information in your question. Questions and results are cached in your browser's local storage.
name: Carotid Artery Occlusion
creation_date: "2026-05-06T03:11:16Z"
updated_date: "2026-05-06T03:41:59Z"
description: >-
Carotid artery occlusion is a cerebrovascular disorder in which complete
obstruction of the extracranial or intracranial carotid arterial lumen,
usually after progressive carotid atherosclerosis, can reduce cerebral or
retinal perfusion and increase risk for transient ischemic attack, ischemic
stroke, and chronic hemodynamic compromise.
category: Complex
disease_term:
preferred_term: carotid artery occlusion
term:
id: MONDO:0004450
label: carotid artery occlusion
parents:
- Vascular disorder
synonyms:
- Carotid occlusive disease
- Internal carotid artery occlusion
- Extracranial internal carotid artery occlusion
- Chronic carotid artery occlusion
- Non-acute carotid artery occlusion
pathophysiology:
- name: Atherosclerotic carotid plaque formation
description: >-
Endothelial injury, lipid retention, foam-cell accumulation, vascular
smooth muscle remodeling, and inflammatory matrix remodeling generate
carotid atherosclerotic plaque. Progressive plaque growth narrows the
lumen and creates the substrate for later thrombosis or complete occlusion.
cell_types:
- preferred_term: endothelial cell
term:
id: CL:0000115
label: endothelial cell
- preferred_term: vascular smooth muscle cell
term:
id: CL:0000359
label: vascular associated smooth muscle cell
- preferred_term: foam cell
term:
id: CL:0000891
label: foam cell
- preferred_term: macrophage
term:
id: CL:0000235
label: macrophage
biological_processes:
- preferred_term: inflammatory response
modifier: INCREASED
term:
id: GO:0006954
label: inflammatory response
- preferred_term: extracellular matrix organization
modifier: ABNORMAL
term:
id: GO:0030198
label: extracellular matrix organization
evidence:
- reference: PMID:37303351
reference_title: "Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
CS is seen undergoing almost the same pathogenesis of any atherosclerotic plaque formation, from endothelial damage of the artery lumen to the formation of a fibrous cap with a foam cell, lipid-filled core.
explanation: This review directly supports endothelial damage, fibrous cap formation, and foam-cell lipid core formation as carotid atherosclerotic plaque biology.
- reference: PMID:39730871
reference_title: Identification of shared genetic etiology of cardiovascular and cerebrovascular diseases through common cardiometabolic risk factors.
supports: SUPPORT
evidence_source: COMPUTATIONAL
snippet: >-
They were enriched in pathways related to cellular response to external stimulus and regulation of the phosphate metabolic process and were highly expressed in endothelial cells, epithelial cells, and smooth muscle cells.
explanation: This multi-trait genetic analysis supports endothelial and smooth-muscle cell involvement in related carotid/cerebrovascular atherosclerotic biology.
downstream:
- target: Thrombotic carotid occlusion
description: Plaque growth and vulnerability can progress to flow-limiting stenosis, thrombosis, or complete occlusion.
- name: Thrombotic carotid occlusion
description: >-
Advanced atherosclerotic plaque and associated thrombus can produce
non-acute or chronic long-segment occlusion of the internal carotid artery.
Occlusion anatomy and plaque location influence recanalization feasibility
and re-occlusion risk.
biological_processes:
- preferred_term: blood coagulation
modifier: INCREASED
term:
id: GO:0007596
label: blood coagulation
evidence:
- reference: PMID:38740919
reference_title: Significance of atherosclerotic plaque location in recanalizing non-acute long-segment occlusion of the internal carotid artery.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
To investigate the significance of atherosclerotic plaque location in hybrid surgery comprising both endovascular recanalization approaches and carotid endarterectomy for symptomatic atherosclerotic non-acute long-segment occlusion of the internal carotid artery (ICA), 162 patients were enrolled, including 120 (74.1%) patients in the proximal plaque group and 42 (25.9%) in the distal plaque group.
explanation: This cohort directly frames non-acute long-segment ICA occlusion as symptomatic atherosclerotic occlusion with plaque-location-dependent outcomes.
- reference: PMID:37813974
reference_title: Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
patients with chronic ICA occlusion treated with endovascular approach only or hybrid surgery were retrospectively enrolled.
explanation: This supports chronic internal carotid artery occlusion as the treated vascular lesion in a human cohort.
downstream:
- target: Cerebral and retinal ischemia
description: Completed carotid occlusion can reduce downstream blood flow or generate embolic ischemia in cerebral and retinal territories.
- name: Cerebral and retinal ischemia
description: >-
Reduced perfusion pressure from carotid occlusion, especially when collateral
circulation is inadequate, and embolic obstruction from carotid plaque or
thrombus can cause transient or permanent cerebral and retinal ischemic
manifestations.
evidence:
- reference: clinicaltrials:NCT00029146
reference_title: Carotid Occlusion Surgery Study
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The purpose of this study is to determine if extracranial-intracranial bypass surgery when added to best medical therapy can reduce the subsequent risk of ipsilateral stroke in high-risk patients with recently symptomatic carotid occlusion and increased cerebral oxygen extraction fraction measured by positron emission tomography (PET).
explanation: This trial summary links symptomatic carotid occlusion with increased oxygen extraction fraction and ipsilateral stroke risk, supporting a hemodynamic ischemia mechanism.
- reference: DOI:10.1093/cvr/cvad135
reference_title: "Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the ESC Council on Stroke and the ESC Working Group on Aorta and Peripheral Vascular Diseases"
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Carotid atherosclerotic disease continues to be an important cause of stroke, often disabling or fatal.
explanation: This consensus abstract supports carotid atherosclerotic disease as a major cause of disabling or fatal stroke.
phenotypes:
- category: Cardiovascular
name: Carotid artery occlusion
diagnostic: true
description: >-
Complete obstruction of a carotid artery is the defining vascular lesion,
often involving the extracranial internal carotid artery in clinical series.
phenotype_term:
preferred_term: Carotid artery occlusion
term:
id: HP:0012474
label: Carotid artery occlusion
evidence:
- reference: PMID:37813974
reference_title: Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The duration of ICA occlusion ranged from 21 to 360 days (median 30).
explanation: This chronic ICA occlusion cohort directly documents internal carotid occlusion duration in affected patients.
- category: Cardiovascular
name: Carotid artery stenosis or near-occlusion
description: >-
Severe carotid stenosis is a precursor and related manifestation on the
same carotid atherosclerotic disease continuum.
phenotype_term:
preferred_term: Carotid artery stenosis
term:
id: HP:0100546
label: Carotid artery stenosis
evidence:
- reference: PMID:39319460
reference_title: Prediction of Severe Baseline Asymptomatic Carotid Stenosis and Subsequent Risk of Stroke and Cardiovascular Disease.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
1662 (6.3%) had severe baseline ACAS.
explanation: This large registry validation documents severe asymptomatic carotid stenosis as a measurable carotid atherosclerotic phenotype.
- category: Neurological
name: Ischemic stroke
description: >-
Cerebral ischemia from carotid occlusive disease may produce ipsilateral
ischemic stroke through embolic or hemodynamic mechanisms.
phenotype_term:
preferred_term: Ischemic stroke
term:
id: HP:0002140
label: Ischemic stroke
evidence:
- reference: clinicaltrials:NCT00029146
reference_title: Carotid Occlusion Surgery Study
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
high-risk patients with recently symptomatic carotid occlusion and increased cerebral oxygen extraction fraction measured by positron emission tomography (PET).
explanation: The trial targets high-risk symptomatic carotid occlusion patients with hemodynamic compromise to prevent subsequent ipsilateral stroke.
- reference: PMID:38896635
reference_title: Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis.
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: >-
Internal carotid artery (ICA) stenosis causes about 15% of ischemic strokes.
explanation: This supports the broader carotid occlusive disease continuum as a cause of ischemic stroke, although the quote addresses stenosis rather than complete occlusion.
- category: Neurological
name: Transient ischemic attack
description: >-
Transient neurologic symptoms can occur when carotid occlusive disease
causes short-lived cerebral ischemia or embolization.
phenotype_term:
preferred_term: Transient ischemic attack
term:
id: HP:0002326
label: Transient ischemic attack
evidence:
- reference: DOI:10.1093/cvr/cvad135
reference_title: "Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the ESC Council on Stroke and the ESC Working Group on Aorta and Peripheral Vascular Diseases"
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: >-
Advancements in discovery research and imaging along with evidence from recent pharmacology and interventional clinical trials and registries and the progress in acute stroke management have markedly expanded the knowledge base for clinical decisions in carotid stenosis.
explanation: This supports carotid stenosis management in stroke-care contexts but is indirect for TIA specifically; TIA is retained as a clinically recognized symptomatic carotid occlusive presentation.
- category: Ophthalmological
name: Amaurosis fugax
description: >-
Transient monocular visual loss can occur when carotid plaque, emboli, or
hypoperfusion transiently compromise retinal circulation.
phenotype_term:
preferred_term: Amaurosis fugax
term:
id: HP:0100576
label: Amaurosis fugax
evidence:
- reference: PMID:37303351
reference_title: "Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications."
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: >-
leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke.
explanation: This supports visual symptoms in carotid stenosis but does not specifically name amaurosis fugax, so support is partial.
- category: Neurological
name: Cerebral ischemia
description: >-
Reduced arterial supply downstream of occlusion can produce cerebral
hypoperfusion even before or without completed infarction.
phenotype_term:
preferred_term: Cerebral ischemia
term:
id: HP:0002637
label: Cerebral ischemia
evidence:
- reference: clinicaltrials:NCT00029146
reference_title: Carotid Occlusion Surgery Study
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
increased cerebral oxygen extraction fraction measured by positron emission tomography (PET).
explanation: Increased oxygen extraction fraction in symptomatic carotid occlusion supports hemodynamic cerebral ischemia.
genetic:
- name: Shared polygenic cardiovascular and cerebrovascular risk loci
association: Risk Factor
presence: Positive
notes: >-
Carotid artery occlusion is not usually monogenic; genetic evidence is best
interpreted as polygenic risk acting through atherosclerosis, blood
pressure, lipid traits, and related cardiometabolic pathways.
evidence:
- reference: PMID:39730871
reference_title: Identification of shared genetic etiology of cardiovascular and cerebrovascular diseases through common cardiometabolic risk factors.
supports: SUPPORT
evidence_source: COMPUTATIONAL
snippet: >-
The 11 loci were mapped to 12 genes, namely CASZ1, CDKN1A, TWIST1, CDKN2B, ABO, SWAP70, SH2B3, LRCH1, FES, GOSR2, RPRML, and LDLR, where both GOSR2 and RPRML were mapped to one locus.
explanation: This supports shared polygenic cardiometabolic loci relevant to carotid and cerebrovascular atherosclerotic disease.
- name: Diabetes-associated genetic markers and carotid plaque
association: Risk Factor
presence: Positive
notes: >-
Diabetes-associated variants may increase carotid plaque risk in some
populations, linking metabolic genetic risk to carotid atherosclerosis.
evidence:
- reference: PMID:36894991
reference_title: "Associations of genetic markers of diabetes mellitus with carotid atherosclerosis: a community-based case-control study."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
We identified 9 DM SNPs showing promising associations with CP.
explanation: This human community case-control study links diabetes-associated SNPs with carotid plaque.
environmental:
- name: Hypertension
presence: Positive
notes: Major atherosclerotic and stroke risk factor associated with carotid plaque development.
evidence:
- reference: PMID:37303351
reference_title: "Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development.
explanation: The review explicitly identifies hypertension among the salient factors in carotid plaque development.
- name: Diabetes mellitus
presence: Positive
notes: Diabetes is a cardiometabolic risk factor for carotid plaque and atherosclerotic disease.
evidence:
- reference: PMID:36894991
reference_title: "Associations of genetic markers of diabetes mellitus with carotid atherosclerosis: a community-based case-control study."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Diabetes mellitus (DM) is a well-established determinant of atherosclerosis and cardiovascular diseases (CVD).
explanation: This supports diabetes as a determinant of atherosclerosis relevant to carotid plaque formation.
- name: Smoking and diet
presence: Positive
notes: Smoking and diet are modifiable lifestyle factors contributing to carotid plaque development.
evidence:
- reference: PMID:37303351
reference_title: "Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
lifestyle aspects, including smoking and diet, played the most salient role in plaque development.
explanation: This directly supports smoking and diet as lifestyle contributors to carotid plaque development.
diagnosis:
- name: Duplex ultrasound and CT angiography
description: >-
Duplex ultrasound is commonly used first line for carotid stenosis and
occlusive disease assessment, with CTA often used to confirm anatomy,
severity, or procedural candidacy.
diagnosis_term:
preferred_term: diagnostic imaging
results: Imaging estimates the severity of carotid stenosis, near-occlusion, or complete occlusion.
evidence:
- reference: PMID:38896635
reference_title: Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Duplex ultrasonography (DUS) is the first line of investigation of ICA stenosis, but its accuracy varies in the literature and it is usual to complement the study with another more accurate exam when faced with significant stenosis.
explanation: This directly supports DUS as first-line imaging and the need for confirmatory imaging in significant stenosis.
- reference: PMID:39143526
reference_title: Systematic review and meta-analysis of the diagnostic value of computed tomography angiography for severe internal carotid artery stenosis.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
CTA demonstrated high sensitivity and specificity for diagnosing severe ICA stenosis.
explanation: This meta-analysis supports CTA as an accurate modality for severe ICA stenosis, relevant to near-occlusive carotid disease.
- name: Hemodynamic evaluation for symptomatic occlusion
description: >-
Perfusion imaging or physiologic assessment can identify hemodynamic
compromise in selected symptomatic carotid occlusion patients.
diagnosis_term:
preferred_term: diagnostic imaging
results: PET or perfusion imaging may demonstrate increased oxygen extraction or hypoperfusion.
evidence:
- reference: clinicaltrials:NCT00029146
reference_title: Carotid Occlusion Surgery Study
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
increased cerebral oxygen extraction fraction measured by positron emission tomography (PET).
explanation: The COSS trial used PET-measured increased oxygen extraction fraction to identify high-risk symptomatic carotid occlusion patients.
- reference: clinicaltrials:NCT06303414
reference_title: Revascularization for Symptomatic Non-acute Carotid Artery Occlusion
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The purpose of this cohort study is to observe the success rate, efficacy and safety of recanalization treatment for non-acute occlusion, and to further compare the advantages and disadvantages of CEA, endovascular intervention and hybrid surgery.
explanation: This trial summary supports specialized evaluation of symptomatic non-acute carotid occlusion for potential recanalization strategies.
treatments:
- name: Optimal medical therapy and risk-factor modification
description: >-
Medical management includes antithrombotic and lipid-lowering strategies,
treatment of vascular risk factors, and lifestyle modification. It remains
foundational even when procedures are considered.
treatment_term:
preferred_term: Pharmacotherapy
term:
id: NCIT:C15986
label: Pharmacotherapy
evidence:
- reference: DOI:10.1093/cvr/cvad135
reference_title: "Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the ESC Council on Stroke and the ESC Working Group on Aorta and Peripheral Vascular Diseases"
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Such strokes could be largely prevented through optimal medical therapy and carotid revascularization.
explanation: This consensus abstract supports optimal medical therapy as a core stroke-prevention strategy in carotid atherosclerotic disease.
- reference: PMID:37303351
reference_title: "Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Both surgical and medical regimens are beneficial in treating patients, but it is still an ongoing debate as to which is predominantly superior.
explanation: This supports medical therapy as a beneficial management component while preserving treatment-selection uncertainty.
- name: Carotid endarterectomy or carotid artery stenting for selected severe stenosis
description: >-
Carotid endarterectomy and carotid artery stenting are procedural options
for selected symptomatic severe carotid stenosis and may be relevant when
occlusion is preceded by surgically treatable severe stenosis.
treatment_term:
preferred_term: surgical procedure
term:
id: MAXO:0000004
label: surgical procedure
evidence:
- reference: PMID:37303351
reference_title: "Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Carotid endarterectomy (CEA) and carotid stenting are the primarily advocated procedures for symptomatic severe stenosis, with similar long-term outcomes.
explanation: This directly supports CEA and carotid stenting for symptomatic severe carotid stenosis.
- reference: PMID:38683353
reference_title: CIRSE Standards of Practice on Carotid Artery Stenting.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
Carotid artery stenting has an established role in the management of internal carotid artery stenosis; this Standards of Practice document provides up-to-date recommendations for its safe performance.
explanation: This standards document supports carotid artery stenting as an established management option for internal carotid artery stenosis.
- name: Endovascular or hybrid recanalization for selected chronic carotid occlusion
description: >-
Specialized centers report endovascular or hybrid recanalization for
selected symptomatic chronic or non-acute long-segment ICA occlusion, but
randomized evidence remains limited and patient selection is critical.
treatment_term:
preferred_term: surgical procedure
term:
id: MAXO:0000004
label: surgical procedure
evidence:
- reference: PMID:37813974
reference_title: Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery.
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
chronic long-segment ICA occlusion can be safely and efficiently recanalized with the endovascular and hybrid surgery.
explanation: This cohort supports feasibility of endovascular or hybrid recanalization in selected chronic long-segment ICA occlusion patients.
- reference: clinicaltrials:NCT03179774
reference_title: Endovascular Revascularization for Chronic Carotid Artery Occlusion Trial
supports: PARTIAL
evidence_source: HUMAN_CLINICAL
snippet: >-
Revascularization for carotid artery occlusion (CAO) remained controversial, there is no prospective randomized control trial (RCT) regarding carotid artery stenting (CAS) in CAO patients.
explanation: This trial summary supports why recanalization should be presented as selected and investigational rather than settled standard care.
clinical_trials:
- name: NCT00029146
phase: NOT_APPLICABLE
status: COMPLETED
description: >-
Carotid Occlusion Surgery Study evaluating extracranial-intracranial bypass
plus best medical therapy for recently symptomatic carotid occlusion with
PET evidence of increased cerebral oxygen extraction.
target_phenotypes:
- preferred_term: Ischemic stroke
term:
id: HP:0002140
label: Ischemic stroke
evidence:
- reference: clinicaltrials:NCT00029146
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The purpose of this study is to determine if extracranial-intracranial bypass surgery when added to best medical therapy can reduce the subsequent risk of ipsilateral stroke in high-risk patients with recently symptomatic carotid occlusion and increased cerebral oxygen extraction fraction measured by positron emission tomography (PET).
explanation: The study directly targets stroke prevention in high-risk symptomatic carotid occlusion.
- name: NCT03179774
phase: NOT_APPLICABLE
status: UNKNOWN
description: >-
ERCAO trial of endovascular revascularization plus optimal medical therapy
versus optimal medical therapy alone for chronic carotid artery occlusion.
target_phenotypes:
- preferred_term: Carotid artery occlusion
term:
id: HP:0012474
label: Carotid artery occlusion
evidence:
- reference: clinicaltrials:NCT03179774
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The investigators conduct a prospective study composed of clinical registry arm and RCT arm.
explanation: This supports an ongoing prospective and randomized clinical research framework for chronic carotid artery occlusion revascularization.
- name: NCT06303414
phase: NOT_APPLICABLE
status: UNKNOWN
description: >-
Observational cohort study of recanalization treatment for symptomatic
non-acute carotid artery occlusion comparing CEA, endovascular intervention,
and hybrid surgery.
target_phenotypes:
- preferred_term: Carotid artery occlusion
term:
id: HP:0012474
label: Carotid artery occlusion
evidence:
- reference: clinicaltrials:NCT06303414
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: >-
The purpose of this cohort study is to observe the success rate, efficacy and safety of recanalization treatment for non-acute occlusion, and to further compare the advantages and disadvantages of CEA, endovascular intervention and hybrid surgery.
explanation: The trial summary directly evaluates recanalization modalities for symptomatic non-acute carotid artery occlusion.
review_notes: >-
The Falcon report emphasized that complete carotid artery occlusion is often
treated in the literature together with severe carotid stenosis and chronic
internal carotid artery occlusion. Stenosis evidence is therefore used only
where it supports the precursor carotid atherosclerotic continuum; complete
occlusion and chronic recanalization claims are supported by CAO/ICAO-specific
cohort or trial records.
Carotid artery occlusion (CAO)—most commonly occlusion of the extracranial internal carotid artery (ICA)—is typically the end stage of carotid atherosclerotic disease and can cause transient ischemic attack (TIA), ischemic stroke, ocular ischemic syndrome, or remain asymptomatic depending on collateral circulation. Contemporary research emphasizes (i) careful phenotyping of acute vs non-acute/chronic occlusions, (ii) improved patient selection using perfusion/hemodynamic markers, and (iii) a shift toward less invasive or hybrid revascularization strategies for selected symptomatic chronic/non-acute ICA occlusion, while optimized medical therapy remains foundational. (zhao2024significanceofatherosclerotic pages 1-2, ren2023recanalizationofchronic pages 8-9, NCT06303414 chunk 2)
| Domain | Key metric (exact number) | Population/study | Year | PMID (if available; otherwise DOI) | URL |
|---|---|---|---|---|---|
| Epidemiology/Risk | Severe baseline asymptomatic carotid artery stenosis (ACAS) prevalence 6.3%; 1,662/26,384 patients; 1,124 strokes and 2,484 CVD events over ~70,000 patient-years; among PACAS score ≥14 (27.7% of cohort), severe ACAS prevalence 11.4%, accounting for 56.6% of incident strokes and 64.9% of incident CVD events (poorthuis2024predictionofsevere pages 1-2) | REACH validation cohort, Poorthuis et al., Stroke | 2024 | DOI: 10.1161/STROKEAHA.123.046894 | https://doi.org/10.1161/strokeaha.123.046894 |
| Epidemiology/Risk | Early recurrence after neurologic index event: 6.4% at 2–3 days, 19.5% at 7 days, 26.1% at 14 days; pooled analysis 5,893 patients, 33,000 patient-years; benefit greatest when revascularization performed within 2 weeks (musialek2025strokeriskmanagement pages 28-29) | Symptomatic carotid stenosis, ESC consensus cited systematic review | 2025 | DOI: 10.1093/cvr/cvad135 | https://doi.org/10.1093/cvr/cvad135 |
| Imaging diagnostics | DUS vs CTA for extracranial ICA stenosis 50–94%: accuracy 69%, sensitivity 89%, specificity 63%; for 70–94%: accuracy 84%, sensitivity 61%, specificity 93%; CTA inter-observer variation 14% vs DUS 3% (daolio2024accuracyofduplex pages 1-2, daolio2024accuracyofduplex pages 4-6, daolio2024accuracyofduplex pages 2-4) | 45 patients, 84 arteries, Daolio et al. | 2024 | DOI: 10.1590/0100-6991e-20243632-en | https://doi.org/10.1590/0100-6991e-20243632-en |
| Imaging diagnostics | CTA meta-analysis for severe ICA stenosis (70–99%): sensitivity 0.93 (95% CI 0.88–0.96), specificity 0.99 (95% CI 0.96–1.00), PLR 92.0, NLR 0.07, DOR 1302, AUC 0.98 (zeng2024systematicreviewand pages 1-2, zeng2024systematicreviewand pages 6-6) | 16 studies, 2,368 vascular segments, Zeng et al. | 2024 | DOI: 10.1186/s12880-024-01390-6 | https://doi.org/10.1186/s12880-024-01390-6 |
| Imaging diagnostics | Color Doppler ultrasound vs DSA: Kappa 0.823, sensitivity 97.67%, specificity 88.24%, accuracy 95.00%; MRA vs DSA: Kappa 0.657, sensitivity 97.30%, specificity 65.22%, accuracy 85.00% (li2026comparativediagnosticvalue pages 1-2) | 120 patients, Li et al. | 2026 | DOI: 10.11152/mu-4590 | https://doi.org/10.11152/mu-4590 |
| Chronic ICA occlusion revascularization outcomes | Chronic long-segment ICA occlusion recanalization: overall success 94.3% (82/87); endovascular-only 93.0% (40/43); hybrid 95.5% (42/44); type I 100%, type II 87.8%; favorable mRS 0–2 in 79.3% overall; overall complications 6.9%; re-occlusion 4.9% overall, 0% in type I vs 9.8–11.1% in type II (ren2023recanalizationofchronic pages 1-2, ren2023recanalizationofchronic pages 7-8, ren2023recanalizationofchronic pages 3-5) | 87 patients, Ren et al., Scientific Reports | 2023 | DOI: 10.1038/s41598-023-44406-x | https://doi.org/10.1038/s41598-023-44406-x |
| Chronic ICA occlusion revascularization outcomes | Symptomatic non-acute long-segment ICA occlusion hybrid recanalization: overall success 97.5% (158/162); proximal plaque 99.2% (119/120); distal plaque 92.9% (39/42); complications 4.2% proximal and 4.8% distal; re-occlusion 2.8% proximal vs 13.3% distal; medically treated annual ipsilateral ischemic stroke risk 3%, rising to 10–20% with severe hemodynamic compromise (zhao2024significanceofatherosclerotic pages 1-2) | 162 patients, Zhao et al., Scientific Reports | 2024 | DOI: 10.1038/s41598-024-61938-y | https://doi.org/10.1038/s41598-024-61938-y |
| CAS standards/complications | Recommended independently assessed in-hospital stroke/death risk after CAS: ≤4% for symptomatic and ≤2% for asymptomatic disease; 30-day rates should not exceed 6% symptomatic and 3% asymptomatic (spiliopoulos2024cirsestandardsof pages 9-10, spiliopoulos2024cirsestandardsof pages 10-11) | CIRSE Standards of Practice on CAS | 2024 | DOI: 10.1007/s00270-024-03707-y | https://doi.org/10.1007/s00270-024-03707-y |
| CAS standards/complications | Transcervical CAS systematic review: technical success 96.3%, open conversion 3.0%, access complications 2.9%, stroke 1.1–1.2%, TIA 2.7%, MI 0.14%, death 0.41%; transradial CAS registry: major access complications 0% vs transfemoral 1.1%, peri-procedural stroke/death 3.3% vs 2.4% (spiliopoulos2024cirsestandardsof pages 9-10) | CAS access-strategy studies summarized in CIRSE guideline | 2024 | DOI: 10.1007/s00270-024-03707-y | https://doi.org/10.1007/s00270-024-03707-y |
| Genetics/molecular | Shared CVD/CeVD/cIMT genetics: 11 colocalized loci, 12 mapped genes (CASZ1, CDKN1A, TWIST1, CDKN2B, ABO, SWAP70, SH2B3, LRCH1, FES, GOSR2, RPRML, LDLR); genetic correlation rg ≈ 0.59; MiXeR estimates ~1.5K causal variants for CAD, ~1.0K for atherosclerosis, with ~0.9K shared variants; methylation signals implicated for CASZ1 and LRCH1 (ding2024identificationofshared pages 1-2, ding2024identificationofshared pages 14-15) | Ding et al., Communications Biology | 2024 | DOI: 10.1038/s42003-024-07417-6 | https://doi.org/10.1038/s42003-024-07417-6 |
| Genetics/molecular | Diabetes-GWAS markers and carotid plaque: 9 SNPs associated (rs4712524, rs1150777, rs10842993, rs2858980, rs9583907, rs1077476, rs7180016, rs4383154, rs9937354); 9-GRS mean 9.19 ± 1.53 vs 8.62 ± 1.63; OR per 1.0 increase in 9-GRS 1.30 (95% CI 1.18–1.44, p=4.7×10^-7); 4-GRS mean 4.02 ± 0.81 vs 3.78 ± 0.92; OR 1.47 (reported 95% CI 1.74–9.40, p=6.1×10^-5) (wu2023associationsofgenetic pages 1-2) | 309 carotid plaque cases, 439 controls, Wu et al. | 2023 | DOI: 10.1186/s12933-023-01787-7 | https://doi.org/10.1186/s12933-023-01787-7 |
Table: This table compiles the main quantitative findings identified across recent carotid occlusion/stenosis literature, spanning epidemiology, imaging accuracy, chronic ICA occlusion revascularization outcomes, carotid stenting standards, and genetics. It is useful as a compact evidence summary for a disease knowledge base entry.
Carotid artery occlusion (CAO) refers to near-complete or complete obstruction of a carotid artery lumen; in clinical cerebrovascular practice, this most often means extracranial internal carotid artery occlusion (ICAO), sometimes including common carotid artery (CCA) occlusion. Definitions vary by imaging modality and clinical context:
Key concept: Clinical consequences depend strongly on collateral flow (circle of Willis/external carotid pathways). Consensus sources note presentations range from asymptomatic to catastrophic depending on collateral capacity. (musialek2025strokeriskmanagement pages 15-16)
Common terms used in recent literature: * Internal carotid artery occlusion (ICAO) / extracranial ICA occlusion (zhang2025spontaneousrecanalizationof pages 1-3) * Chronic ICA occlusion, non-acute ICA occlusion, chronic long-segment ICA occlusion (zhao2024significanceofatherosclerotic pages 1-2, ren2023recanalizationofchronic pages 8-9) * Carotid artery disease / carotid atherosclerotic disease when CAO is treated as the end-stage of stenosis/plaque (musialek2025strokeriskmanagement pages 28-29)
The evidence synthesized here is from aggregated disease-level resources: cohort studies, systematic reviews/meta-analyses, consensus statements, procedure standards, and ClinicalTrials.gov protocols—not individual EHR case extraction. (ren2023recanalizationofchronic pages 8-9, spiliopoulos2024cirsestandardsof pages 5-6, NCT06303414 chunk 2)
Atherosclerotic plaque progression with superimposed thrombosis is the leading cause of extracranial ICA occlusion in older populations, and is conceptually an extreme on the carotid stenosis continuum. Mechanistically, plaques arise via endothelial dysfunction and inflammatory lipid accumulation with fibrous cap formation; advanced lesions can thrombose and occlude. (ismail2023carotidarterystenosis pages 8-10, ren2023recanalizationofchronic pages 8-9)
Non-atherosclerotic etiologies include carotid dissection and other less common arteriopathies (examples appear in related occlusion literature and trial inclusion allowing various etiologies). (zhang2025spontaneousrecanalizationof pages 1-3)
Risk factors align with systemic atherosclerosis and stroke prevention frameworks: * Hypertension and diabetes are common comorbidities in chronic occlusion intervention cohorts (e.g., hypertension 75.7%, diabetes 31.1% reported in a chronic cerebral artery occlusion recanalization cohort that included ICA occlusion cases). (zhao2024significanceofatherosclerotic pages 1-2) * Smoking is both a risk factor for carotid atherosclerotic progression and is a predictor in some recanalization success models; in one chronic occlusion cohort 36.9% had smoking history and smoking history was independently associated with recanalization success. (zhao2024significanceofatherosclerotic pages 1-2)
Direct protective factors specifically for CAO are not consistently quantified in the retrieved 2023–2024 CAO-focused evidence. However, guideline-consensus sources emphasize aggressive risk factor control and modern medical therapy to lower carotid-related stroke risk. (musialek2025strokeriskmanagement pages 57-58)
Direct gene×environment interaction studies for CAO were not captured in the retrieved set. Nonetheless, several genetic studies implicate pathways (BP regulation, lipid biology, inflammation) whose phenotypic expression is strongly modified by lifestyle and medical therapy, supporting a systems-level G×E view. (ding2024identificationofshared pages 1-2, wu2023associationsofgenetic pages 1-2)
Below are common CAO-associated phenotypes; frequencies are variable and depend on collateral circulation and the presence of embolic sources.
1) Ischemic stroke / cerebral infarction (often carotid-territory) * Phenotype type: clinical event * HPO: Cerebral infarction (HP:0001344), Ischemic stroke (HP:0002140) * Notes: Chronic ICA occlusion is associated with substantial recurrent ipsilateral stroke risk despite medical therapy in historical cohorts (6–20%/year cited) and procedure series cite this as rationale for intervention in selected cases. (ren2023recanalizationofchronic pages 1-2)
2) Transient ischemic attack (TIA) including hemodynamic presentations * Phenotype type: symptom complex * HPO: Transient ischemic attack (HP:0002326) * Special phenotype: limb-shaking TIA is described as hemodynamic, related to carotid stenosis/occlusion and impaired perfusion. (musialek2025strokeriskmanagement pages 15-16)
3) Ocular ischemic phenomena (amaurosis fugax/ocular ischemic syndrome) * Phenotype type: symptom/sign * HPO: Amaurosis fugax (HP:0001105) (term usage may vary) * Notes: Some carotid stenosis/occlusion cohorts emphasize retinal ischemia as a marker of symptomatic carotid disease. (daolio2024accuracyofduplex pages 2-4)
4) Hemodynamic impairment / hypoperfusion * Phenotype type: imaging/physiology abnormality * HPO: Cerebral hypoperfusion (closest HPO term may differ by ontology version) * Notes: Non-acute CAO interventional trials require perfusion-confirmed hypoperfusion for enrollment. (NCT06303414 chunk 2)
Quality of life impact is driven by stroke disability and recurrent ischemia. Clinical trial outcomes for surgical bypass in symptomatic ICA occlusion include disability and stroke-specific QOL instruments (e.g., Rankin, Barthel, SS-QOL). (NCT00029146 chunk 2)
CAO is not typically monogenic; it is usually a downstream vascular phenotype of polygenic atherosclerosis risk, thrombosis risk, or arteriopathy (e.g., dissection, moyamoya-spectrum in selected populations).
Shared cardiometabolic genetics relevant to carotid atherosclerosis (proxy: cIMT): A 2024 multi-trait genetic study identified 11 colocalized loci mapped to CASZ1, CDKN1A, TWIST1, CDKN2B, ABO, SWAP70, SH2B3, LRCH1, FES, GOSR2, RPRML, LDLR, and suggested methylation of CASZ1 and LRCH1 as potentially causal mediators. Quantitative overlap estimates reported high genetic sharing (rg ≈ 0.59; ~0.9K shared causal variants). (ding2024identificationofshared pages 1-2, ding2024identificationofshared pages 14-15)
Diabetes-GWAS markers linked to carotid plaque: A 2023 community-based case–control analysis associated 9 diabetes GWAS SNPs with carotid plaque and reported polygenic risk score odds ratios (e.g., OR 1.30 per 1.0 increase in 9-locus GRS). (wu2023associationsofgenetic pages 1-2)
Endothelial/plaque biology candidates and epigenetic mechanisms (systematic review): Endothelial genetics/transcriptomics evidence emphasizes matrix remodeling and plaque progression pathways with candidates including MMP1 and ADAM9/15/17, and highlights flow/shear-stress–driven epigenetic regulation (DNA methylation, chromatin remodeling) and histone deacetylase biology (HDAC9). (richter2025endothelialcellgenetics pages 6-7, richter2025endothelialcellgenetics pages 14-15)
Epigenetic regulation is implicated at two levels in the retrieved evidence: * Genetic multi-omics analyses suggesting methylation-mediated pleiotropy (CASZ1, LRCH1). (ding2024identificationofshared pages 1-2, ding2024identificationofshared pages 14-15) * Endothelial shear-stress–induced epigenetic changes (flow-dependent methylation and chromatin remodeling) in atherosclerosis biology. (richter2025endothelialcellgenetics pages 14-15)
Mouse vascular integrity genes (e.g., COL4A1) appear in broader cerebrovascular atherosclerosis genetics reviews but were not directly tied to CAO as a discrete phenotype in the retrieved set. (richter2025endothelialcellgenetics pages 11-12)
The disease is tightly linked to modifiable atherosclerosis risk factors (smoking, diet, activity) and metabolic disease burden. Intervention cohorts and reviews highlight smoking and cardiometabolic comorbidities as common features. (zhao2024significanceofatherosclerotic pages 1-2, ismail2023carotidarterystenosis pages 8-10)
No infectious causal triggers were identified in the retrieved evidence set for CAO.
Key involved cell types (by current atherosclerosis biology and retrieved endothelial-focused evidence): * Endothelial cell (CL:0000115) (richter2025endothelialcellgenetics pages 1-2) * Vascular smooth muscle cell (CL:0000192) (implicated by vascular remodeling and gene expression enrichment) (ding2024identificationofshared pages 1-2) * Macrophage (CL:0000235) (ADAM genes upregulated in advanced plaques) (richter2025endothelialcellgenetics pages 14-15)
Operational definitions in recent chronic/non-acute cohorts: >7 days (non-acute) and >3 weeks (chronic). (zhao2024significanceofatherosclerotic pages 1-2, ren2023recanalizationofchronic pages 8-9)
In practice, clinicians distinguish: * severe stenosis → near-occlusion → occlusion; * acute thrombotic occlusion vs chronic organized occlusion (recanalization feasibility differs).
Direct population incidence/prevalence of ICA occlusion was not captured in the retrieved 2023–2024 primary epidemiology set. However, related high-quality epidemiology for severe asymptomatic carotid stenosis (a major precursor phenotype) is available: * Severe baseline ACAS prevalence 6.3% in 26,384 patients (REACH registry validation), with risk concentrated in high PACAS score strata. (poorthuis2024predictionofsevere pages 1-2)
CAO/ICAO recurrence risk under medical therapy is often cited from historical cohorts: * Annual ipsilateral stroke risk ~3% in medically treated chronic CAO, increasing to 10–20% with severe hemodynamic compromise (cited in a 2024 intervention series). (zhao2024significanceofatherosclerotic pages 1-2)
The genetic architecture is polygenic/multifactorial. Recent multi-trait analyses suggest thousands of causal variants for related atherosclerosis phenotypes and substantial sharing with CAD. (ding2024identificationofshared pages 1-2)
Measurement caveat: Consensus sources stress that stenosis severity can be center- and modality-dependent; one cited comparison indicates that with DUS, “1 out of 6 arteries would be reclassified by CTA.” (musialek2025strokeriskmanagement pages 18-19)
For symptomatic non-acute CAO intervention selection, protocols require perfusion evidence of hypoperfusion and exclude large new infarcts on MRI DWI/ADC. (NCT06303414 chunk 2)
Chronic ICA occlusion is cited as carrying substantial recurrent stroke risk despite medical therapy: * Yearly ipsilateral recurrent stroke risk 6–20% is cited in a 2023 chronic ICA occlusion series as background rationale. (ren2023recanalizationofchronic pages 1-2)
Modern carotid consensus emphasizes aggressive risk factor management (“goal-directed triple medical therapy” plus lifestyle modification), recognizing residual stroke risk remains in selected high-risk patients. (musialek2025strokeriskmanagement pages 57-58)
A 2023 review summarizes that guidelines recommend revascularization in symptomatic stenosis >50% and note comparative trial evidence between CEA and CAS with similar long-term ipsilateral stroke rates but different periprocedural risks; selected numeric trial outcomes are reported (e.g., NASCET perioperative stroke/death 6.5%). (ismail2023carotidarterystenosis pages 8-10)
CIRSE 2024 CAS SOP (practice standards): * Recommends structured procedural technique and embolic protection usage. * Provides quality thresholds (from ESO expert consensus) suggesting in-hospital stroke/death risk after CAS should not exceed 4% symptomatic and 2% asymptomatic, with 30-day rates ≤6% and ≤3% respectively. (spiliopoulos2024cirsestandardsof pages 9-10)
The SOP’s indications/contraindications are captured in the retrieved cropped guideline text images. (spiliopoulos2024cirsestandardsof media 6e47be29, spiliopoulos2024cirsestandardsof media 55399623)
Hybrid or endovascular recanalization is increasingly reported in selected symptomatic chronic/non-acute long-segment ICA occlusion cohorts: * 2023 cohort: overall success 94.3% (82/87); complications 6.9%; re-occlusion 4.9%. (ren2023recanalizationofchronic pages 3-5) * 2024 cohort: overall success 97.5% (158/162); low reported periprocedural complications (~4–5%); re-occlusion differed by plaque location (2.8% vs 13.3%). (zhao2024significanceofatherosclerotic pages 1-2)
MAXO suggestions (interventions): * Carotid endarterectomy (MAXO:??) * Carotid artery stenting / endovascular recanalization (MAXO:??) * Extracranial–intracranial bypass (MAXO:??)
(Exact MAXO IDs were not available in retrieved sources and would require ontology lookup.)
Risk-factor modification to prevent carotid atherosclerosis progression (BP control, diabetes management, smoking cessation) is central; evidence is consistent with broader stroke prevention consensus emphasizing medical therapy uptake and lifestyle modification. (musialek2025strokeriskmanagement pages 57-58)
Selective screening for severe asymptomatic stenosis may be guided by risk models; a 2024 validation study suggests high PACAS risk groups concentrate stroke/CVD events and may support targeted screening strategies. (poorthuis2024predictionofsevere pages 1-2)
In established symptomatic disease, timely revascularization for stenosis can reduce recurrent stroke risk, and selected chronic occlusion patients may be considered for recanalization trials or specialized interventions. (musialek2025strokeriskmanagement pages 28-29, NCT03179774 chunk 1)
Non-human naturally occurring ICA occlusion is reported in veterinary anatomical studies (e.g., Japanese Black cattle ICA occlusion/closure patterns), but this is not a translational disease model for human atherosclerotic CAO. (musialek2025strokeriskmanagement pages 57-58)
Common experimental models relevant to CAO mechanisms (not comprehensively retrieved here) include bilateral common carotid artery occlusion (BCCAO) in rodents used for chronic hypoperfusion studies. (musialek2025strokeriskmanagement pages 57-58)
(Additional verbatim abstract quotes from older landmark RCTs such as NASCET/CREST/ACST were not retrieved as full abstracts in this evidence set; the numeric summaries reported in secondary sources should be verified against primary trial abstracts/PMIDs for a production-grade knowledge base.) (ismail2023carotidarterystenosis pages 8-10)
References
(zhao2024significanceofatherosclerotic pages 1-2): Tong-Yuan Zhao, Gang-Qin Xu, Jiang-Yu Xue, Wei-Xing Bai, Dong-Yang Cai, Bo-Wen Yang, Wei-Yu Shi, Tian-Xiao Li, and Bu-Lang Gao. Significance of atherosclerotic plaque location in recanalizing non-acute long-segment occlusion of the internal carotid artery. Scientific Reports, May 2024. URL: https://doi.org/10.1038/s41598-024-61938-y, doi:10.1038/s41598-024-61938-y. This article has 4 citations and is from a peer-reviewed journal.
(ren2023recanalizationofchronic pages 8-9): Wei Ren, Jiangyu Xue, Tongyuan Zhao, Gangqin Xu, Bowen Yang, Tianxiao Li, and Bulang Gao. Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery. Scientific Reports, Oct 2023. URL: https://doi.org/10.1038/s41598-023-44406-x, doi:10.1038/s41598-023-44406-x. This article has 9 citations and is from a peer-reviewed journal.
(NCT06303414 chunk 2): Revascularization for Symptomatic Non-acute Carotid Artery Occlusion. Xuanwu Hospital, Beijing. 2016. ClinicalTrials.gov Identifier: NCT06303414
(poorthuis2024predictionofsevere pages 1-2): MD Michiel H.F. Poorthuis, PhD Steven H.J. Hageman, PhD Aernoud, MD T.L. Fiolet, PhD Jaap Kappelle, PhD Michiel L. Bots, P. Steg, MD Frank L.J. Visseren, PhD Deepak L. Bhatt, and M. M. G. J. D. Md. Prediction of severe baseline asymptomatic carotid stenosis and subsequent risk of stroke and cardiovascular disease. Stroke, 55:2632-2640, Nov 2024. URL: https://doi.org/10.1161/strokeaha.123.046894, doi:10.1161/strokeaha.123.046894. This article has 13 citations and is from a highest quality peer-reviewed journal.
(musialek2025strokeriskmanagement pages 28-29): Piotr Musialek, Leo H Bonati, Richard Bulbulia, Alison Halliday, Birgit Bock, Laura Capoccia, Hans-Henning Eckstein, Iris Q Grunwald, Peck Lin Lip, Andre Monteiro, Kosmas I Paraskevas, Anna Podlasek, Barbara Rantner, Kenneth Rosenfield, Adnan H Siddiqui, Henrik Sillesen, Isabelle Van Herzeele, Tomasz J Guzik, Lucia Mazzolai, Victor Aboyans, and Gregory Y H Lip. Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the esc council on stroke and the esc working group on aorta and peripheral vascular diseases. Cardiovascular Research, 121:13-43, Aug 2025. URL: https://doi.org/10.1093/cvr/cvad135, doi:10.1093/cvr/cvad135. This article has 51 citations and is from a domain leading peer-reviewed journal.
(daolio2024accuracyofduplex pages 1-2): RAUL MUFFATO DAOLIO, LUIZ FERNANDO SANTETTI ZANIN, CAROLINA DUTRA QUEIROZ FLUMIGNAN, NICOLLE CASSOLA, HENRIQUE JORGE GUEDES NETO, JOSÉ EDUARDO MOURÃO SANTOS, JORGE EDUARDO AMORIM, LUÍS CARLOS UTA NAKANO, and RONALD LUIZ GOMES FLUMIGNAN. Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis. Revista do Colégio Brasileiro de Cirurgiões, May 2024. URL: https://doi.org/10.1590/0100-6991e-20243632-en, doi:10.1590/0100-6991e-20243632-en. This article has 7 citations.
(daolio2024accuracyofduplex pages 4-6): RAUL MUFFATO DAOLIO, LUIZ FERNANDO SANTETTI ZANIN, CAROLINA DUTRA QUEIROZ FLUMIGNAN, NICOLLE CASSOLA, HENRIQUE JORGE GUEDES NETO, JOSÉ EDUARDO MOURÃO SANTOS, JORGE EDUARDO AMORIM, LUÍS CARLOS UTA NAKANO, and RONALD LUIZ GOMES FLUMIGNAN. Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis. Revista do Colégio Brasileiro de Cirurgiões, May 2024. URL: https://doi.org/10.1590/0100-6991e-20243632-en, doi:10.1590/0100-6991e-20243632-en. This article has 7 citations.
(daolio2024accuracyofduplex pages 2-4): RAUL MUFFATO DAOLIO, LUIZ FERNANDO SANTETTI ZANIN, CAROLINA DUTRA QUEIROZ FLUMIGNAN, NICOLLE CASSOLA, HENRIQUE JORGE GUEDES NETO, JOSÉ EDUARDO MOURÃO SANTOS, JORGE EDUARDO AMORIM, LUÍS CARLOS UTA NAKANO, and RONALD LUIZ GOMES FLUMIGNAN. Accuracy of duplex ultrasonography versus angiotomography for the diagnosis of extracranial internal carotid stenosis. Revista do Colégio Brasileiro de Cirurgiões, May 2024. URL: https://doi.org/10.1590/0100-6991e-20243632-en, doi:10.1590/0100-6991e-20243632-en. This article has 7 citations.
(zeng2024systematicreviewand pages 1-2): Han-Lin Zeng, Fu-Qiang Shao, Xian-Feng Peng, and Chun-Yu Lei. Systematic review and meta-analysis of the diagnostic value of computed tomography angiography for severe internal carotid artery stenosis. BMC Medical Imaging, Aug 2024. URL: https://doi.org/10.1186/s12880-024-01390-6, doi:10.1186/s12880-024-01390-6. This article has 6 citations and is from a peer-reviewed journal.
(zeng2024systematicreviewand pages 6-6): Han-Lin Zeng, Fu-Qiang Shao, Xian-Feng Peng, and Chun-Yu Lei. Systematic review and meta-analysis of the diagnostic value of computed tomography angiography for severe internal carotid artery stenosis. BMC Medical Imaging, Aug 2024. URL: https://doi.org/10.1186/s12880-024-01390-6, doi:10.1186/s12880-024-01390-6. This article has 6 citations and is from a peer-reviewed journal.
(li2026comparativediagnosticvalue pages 1-2): Wei Li, Jin Wang, Yuan-Zheng Zhu, and Jie Liu. Comparative diagnostic value of carotid colour doppler ultrasound and carotid magnetic resonance angiography in detecting carotid artery stenosis. Medical Ultrasonography, Feb 2026. URL: https://doi.org/10.11152/mu-4590, doi:10.11152/mu-4590. This article has 0 citations.
(ren2023recanalizationofchronic pages 1-2): Wei Ren, Jiangyu Xue, Tongyuan Zhao, Gangqin Xu, Bowen Yang, Tianxiao Li, and Bulang Gao. Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery. Scientific Reports, Oct 2023. URL: https://doi.org/10.1038/s41598-023-44406-x, doi:10.1038/s41598-023-44406-x. This article has 9 citations and is from a peer-reviewed journal.
(ren2023recanalizationofchronic pages 7-8): Wei Ren, Jiangyu Xue, Tongyuan Zhao, Gangqin Xu, Bowen Yang, Tianxiao Li, and Bulang Gao. Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery. Scientific Reports, Oct 2023. URL: https://doi.org/10.1038/s41598-023-44406-x, doi:10.1038/s41598-023-44406-x. This article has 9 citations and is from a peer-reviewed journal.
(ren2023recanalizationofchronic pages 3-5): Wei Ren, Jiangyu Xue, Tongyuan Zhao, Gangqin Xu, Bowen Yang, Tianxiao Li, and Bulang Gao. Recanalization of chronic long-segment occlusion of the internal carotid artery with endovascular and hybrid surgery. Scientific Reports, Oct 2023. URL: https://doi.org/10.1038/s41598-023-44406-x, doi:10.1038/s41598-023-44406-x. This article has 9 citations and is from a peer-reviewed journal.
(spiliopoulos2024cirsestandardsof pages 9-10): Stavros Spiliopoulos, Raphaël Blanc, Roberto Gandini, Stefan Müller-Hülsbeck, Wolfgang Reith, and Ornella Moschovaki-Zeiger. Cirse standards of practice on carotid artery stenting. Cardiovascular and Interventional Radiology, 47:705-716, Apr 2024. URL: https://doi.org/10.1007/s00270-024-03707-y, doi:10.1007/s00270-024-03707-y. This article has 18 citations and is from a peer-reviewed journal.
(spiliopoulos2024cirsestandardsof pages 10-11): Stavros Spiliopoulos, Raphaël Blanc, Roberto Gandini, Stefan Müller-Hülsbeck, Wolfgang Reith, and Ornella Moschovaki-Zeiger. Cirse standards of practice on carotid artery stenting. Cardiovascular and Interventional Radiology, 47:705-716, Apr 2024. URL: https://doi.org/10.1007/s00270-024-03707-y, doi:10.1007/s00270-024-03707-y. This article has 18 citations and is from a peer-reviewed journal.
(ding2024identificationofshared pages 1-2): Kexin Ding, Xueying Qin, Huairong Wang, Kun Wang, Xiaoying Kang, Yao Yu, Yang Liu, Haiying Gong, Tao Wu, Dafang Chen, Yonghua Hu, Tao Wang, and Yiqun Wu. Identification of shared genetic etiology of cardiovascular and cerebrovascular diseases through common cardiometabolic risk factors. Communications Biology, Dec 2024. URL: https://doi.org/10.1038/s42003-024-07417-6, doi:10.1038/s42003-024-07417-6. This article has 10 citations and is from a peer-reviewed journal.
(ding2024identificationofshared pages 14-15): Kexin Ding, Xueying Qin, Huairong Wang, Kun Wang, Xiaoying Kang, Yao Yu, Yang Liu, Haiying Gong, Tao Wu, Dafang Chen, Yonghua Hu, Tao Wang, and Yiqun Wu. Identification of shared genetic etiology of cardiovascular and cerebrovascular diseases through common cardiometabolic risk factors. Communications Biology, Dec 2024. URL: https://doi.org/10.1038/s42003-024-07417-6, doi:10.1038/s42003-024-07417-6. This article has 10 citations and is from a peer-reviewed journal.
(wu2023associationsofgenetic pages 1-2): Tzu-Wei Wu, Chao-Liang Chou, Chun-Fang Cheng, Shu-Xin Lu, Yih-Jer Wu, and Li-Yu Wang. Associations of genetic markers of diabetes mellitus with carotid atherosclerosis: a community-based case–control study. Cardiovascular Diabetology, Mar 2023. URL: https://doi.org/10.1186/s12933-023-01787-7, doi:10.1186/s12933-023-01787-7. This article has 10 citations and is from a peer-reviewed journal.
(musialek2025strokeriskmanagement pages 15-16): Piotr Musialek, Leo H Bonati, Richard Bulbulia, Alison Halliday, Birgit Bock, Laura Capoccia, Hans-Henning Eckstein, Iris Q Grunwald, Peck Lin Lip, Andre Monteiro, Kosmas I Paraskevas, Anna Podlasek, Barbara Rantner, Kenneth Rosenfield, Adnan H Siddiqui, Henrik Sillesen, Isabelle Van Herzeele, Tomasz J Guzik, Lucia Mazzolai, Victor Aboyans, and Gregory Y H Lip. Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the esc council on stroke and the esc working group on aorta and peripheral vascular diseases. Cardiovascular Research, 121:13-43, Aug 2025. URL: https://doi.org/10.1093/cvr/cvad135, doi:10.1093/cvr/cvad135. This article has 51 citations and is from a domain leading peer-reviewed journal.
(NCT00029146 chunk 2): William Powers. Carotid Occlusion Surgery Study. University of North Carolina, Chapel Hill. 2002. ClinicalTrials.gov Identifier: NCT00029146
(zhang2025spontaneousrecanalizationof pages 1-3): Sarah Y. Zhang, Hee Sahng Chung, Brian Dewar, Robert Fahed, Michel Shamy, Risa Shorr, and Dar Dowlatshahi. Spontaneous recanalization of extracranial internal carotid occlusion: a systematic scoping review. PLOS One, 20:e0326261, Jul 2025. URL: https://doi.org/10.1371/journal.pone.0326261, doi:10.1371/journal.pone.0326261. This article has 0 citations and is from a peer-reviewed journal.
(spiliopoulos2024cirsestandardsof pages 5-6): Stavros Spiliopoulos, Raphaël Blanc, Roberto Gandini, Stefan Müller-Hülsbeck, Wolfgang Reith, and Ornella Moschovaki-Zeiger. Cirse standards of practice on carotid artery stenting. Cardiovascular and Interventional Radiology, 47:705-716, Apr 2024. URL: https://doi.org/10.1007/s00270-024-03707-y, doi:10.1007/s00270-024-03707-y. This article has 18 citations and is from a peer-reviewed journal.
(ismail2023carotidarterystenosis pages 8-10): Aqsa Ismail, Shivani Ravipati, Diana Gonzalez-Hernandez, Hashim Mahmood, Alizay Imran, Eduardo J Munoz, Saad Naeem, Zain U Abdin, and Humza F Siddiqui. Carotid artery stenosis: a look into the diagnostic and management strategies, and related complications. Cureus, May 2023. URL: https://doi.org/10.7759/cureus.38794, doi:10.7759/cureus.38794. This article has 51 citations.
(musialek2025strokeriskmanagement pages 57-58): Piotr Musialek, Leo H Bonati, Richard Bulbulia, Alison Halliday, Birgit Bock, Laura Capoccia, Hans-Henning Eckstein, Iris Q Grunwald, Peck Lin Lip, Andre Monteiro, Kosmas I Paraskevas, Anna Podlasek, Barbara Rantner, Kenneth Rosenfield, Adnan H Siddiqui, Henrik Sillesen, Isabelle Van Herzeele, Tomasz J Guzik, Lucia Mazzolai, Victor Aboyans, and Gregory Y H Lip. Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the esc council on stroke and the esc working group on aorta and peripheral vascular diseases. Cardiovascular Research, 121:13-43, Aug 2025. URL: https://doi.org/10.1093/cvr/cvad135, doi:10.1093/cvr/cvad135. This article has 51 citations and is from a domain leading peer-reviewed journal.
(richter2025endothelialcellgenetics pages 6-7): Kent R. Richter, Patrick King, Mason Masters, Omid Shoraka, Michael T. Bounajem, Leo J. Y. Kim, Sarah Dabb, Sarah Nguyen, Jennifer J. Majersik, Aaron Shoskes, Kendell Clement, Ethan Winkler, Ramesh Grandhi, and Karol P. Budohoski. Endothelial cell genetics in carotid artery atherosclerosis and intracranial atherosclerosis: a systematic review. Stroke: Vascular and Interventional Neurology, Nov 2025. URL: https://doi.org/10.1161/svin.125.001813, doi:10.1161/svin.125.001813. This article has 0 citations.
(richter2025endothelialcellgenetics pages 14-15): Kent R. Richter, Patrick King, Mason Masters, Omid Shoraka, Michael T. Bounajem, Leo J. Y. Kim, Sarah Dabb, Sarah Nguyen, Jennifer J. Majersik, Aaron Shoskes, Kendell Clement, Ethan Winkler, Ramesh Grandhi, and Karol P. Budohoski. Endothelial cell genetics in carotid artery atherosclerosis and intracranial atherosclerosis: a systematic review. Stroke: Vascular and Interventional Neurology, Nov 2025. URL: https://doi.org/10.1161/svin.125.001813, doi:10.1161/svin.125.001813. This article has 0 citations.
(richter2025endothelialcellgenetics pages 11-12): Kent R. Richter, Patrick King, Mason Masters, Omid Shoraka, Michael T. Bounajem, Leo J. Y. Kim, Sarah Dabb, Sarah Nguyen, Jennifer J. Majersik, Aaron Shoskes, Kendell Clement, Ethan Winkler, Ramesh Grandhi, and Karol P. Budohoski. Endothelial cell genetics in carotid artery atherosclerosis and intracranial atherosclerosis: a systematic review. Stroke: Vascular and Interventional Neurology, Nov 2025. URL: https://doi.org/10.1161/svin.125.001813, doi:10.1161/svin.125.001813. This article has 0 citations.
(musialek2025strokeriskmanagement pages 50-51): Piotr Musialek, Leo H Bonati, Richard Bulbulia, Alison Halliday, Birgit Bock, Laura Capoccia, Hans-Henning Eckstein, Iris Q Grunwald, Peck Lin Lip, Andre Monteiro, Kosmas I Paraskevas, Anna Podlasek, Barbara Rantner, Kenneth Rosenfield, Adnan H Siddiqui, Henrik Sillesen, Isabelle Van Herzeele, Tomasz J Guzik, Lucia Mazzolai, Victor Aboyans, and Gregory Y H Lip. Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the esc council on stroke and the esc working group on aorta and peripheral vascular diseases. Cardiovascular Research, 121:13-43, Aug 2025. URL: https://doi.org/10.1093/cvr/cvad135, doi:10.1093/cvr/cvad135. This article has 51 citations and is from a domain leading peer-reviewed journal.
(richter2025endothelialcellgenetics pages 1-2): Kent R. Richter, Patrick King, Mason Masters, Omid Shoraka, Michael T. Bounajem, Leo J. Y. Kim, Sarah Dabb, Sarah Nguyen, Jennifer J. Majersik, Aaron Shoskes, Kendell Clement, Ethan Winkler, Ramesh Grandhi, and Karol P. Budohoski. Endothelial cell genetics in carotid artery atherosclerosis and intracranial atherosclerosis: a systematic review. Stroke: Vascular and Interventional Neurology, Nov 2025. URL: https://doi.org/10.1161/svin.125.001813, doi:10.1161/svin.125.001813. This article has 0 citations.
(musialek2025strokeriskmanagement pages 18-19): Piotr Musialek, Leo H Bonati, Richard Bulbulia, Alison Halliday, Birgit Bock, Laura Capoccia, Hans-Henning Eckstein, Iris Q Grunwald, Peck Lin Lip, Andre Monteiro, Kosmas I Paraskevas, Anna Podlasek, Barbara Rantner, Kenneth Rosenfield, Adnan H Siddiqui, Henrik Sillesen, Isabelle Van Herzeele, Tomasz J Guzik, Lucia Mazzolai, Victor Aboyans, and Gregory Y H Lip. Stroke risk management in carotid atherosclerotic disease: a clinical consensus statement of the esc council on stroke and the esc working group on aorta and peripheral vascular diseases. Cardiovascular Research, 121:13-43, Aug 2025. URL: https://doi.org/10.1093/cvr/cvad135, doi:10.1093/cvr/cvad135. This article has 51 citations and is from a domain leading peer-reviewed journal.
(spiliopoulos2024cirsestandardsof media 6e47be29): Stavros Spiliopoulos, Raphaël Blanc, Roberto Gandini, Stefan Müller-Hülsbeck, Wolfgang Reith, and Ornella Moschovaki-Zeiger. Cirse standards of practice on carotid artery stenting. Cardiovascular and Interventional Radiology, 47:705-716, Apr 2024. URL: https://doi.org/10.1007/s00270-024-03707-y, doi:10.1007/s00270-024-03707-y. This article has 18 citations and is from a peer-reviewed journal.
(spiliopoulos2024cirsestandardsof media 55399623): Stavros Spiliopoulos, Raphaël Blanc, Roberto Gandini, Stefan Müller-Hülsbeck, Wolfgang Reith, and Ornella Moschovaki-Zeiger. Cirse standards of practice on carotid artery stenting. Cardiovascular and Interventional Radiology, 47:705-716, Apr 2024. URL: https://doi.org/10.1007/s00270-024-03707-y, doi:10.1007/s00270-024-03707-y. This article has 18 citations and is from a peer-reviewed journal.
(NCT03179774 chunk 1): Endovascular Revascularization for Chronic Carotid Artery Occlusion Trial. National Taiwan University Hospital. 2017. ClinicalTrials.gov Identifier: NCT03179774