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Scientific article
Review
Open access
English

Non-stenotic Carotid Plaques in Embolic Stroke of Unknown Source

Published inFrontiers in neurology, vol. 12, 719329
Publication date2021
First online date2021-09-22
Abstract

Embolic stroke of unknown source (ESUS) represents one in five ischemic strokes. Ipsilateral non-stenotic carotid plaques are identified in 40% of all ESUS. In this narrative review, we summarize the evidence supporting the potential causal relationship between ESUS and non-stenotic carotid plaques; discuss the remaining challenges in establishing the causal link between non-stenotic plaques and ESUS and describe biomarkers of potential interest for future research. In support of the causal relationship between ESUS and non-stenotic carotid plaques, studies have shown that plaques with high-risk features are five times more prevalent in the ipsilateral vs. the contralateral carotid and there is a lower incidence of atrial fibrillation during follow-up in patients with ipsilateral non-stenotic carotid plaques. However, non-stenotic carotid plaques with or without high-risk features often coexist with other potential etiologies of stroke, notably atrial fibrillation (8.5%), intracranial atherosclerosis (8.4%), patent foramen ovale (5-9%), and atrial cardiopathy (2.4%). Such puzzling clinical associations make it challenging to confirm the causal link between non-stenotic plaques and ESUS. There are several ongoing studies exploring whether select protein and RNA biomarkers of plaque progression or vulnerability could facilitate the reclassification of some ESUS as large vessel strokes or help to optimize secondary prevention strategies.

eng
Keywords
  • Atherosclerosis
  • Biomarkers
  • Carotid plaque
  • Carotid stenosis
  • Stroke
Citation (ISO format)
KAMTCHUM-TATUENE, Joseph et al. Non-stenotic Carotid Plaques in Embolic Stroke of Unknown Source. In: Frontiers in neurology, 2021, vol. 12, p. 719329. doi: 10.3389/fneur.2021.719329
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Article (Published version)
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ISSN of the journal1664-2295
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Creation10/19/2021 12:46:00 PM
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