{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T07:10:34Z","timestamp":1788678634003,"version":"build-2803163510"},"reference-count":30,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jvascsurg.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Vascular Surgery"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.jvs.2026.08.002","type":"journal-article","created":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T05:25:05Z","timestamp":1786253105000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptomatic \u226450% carotid artery stenosis is associated with higher rates of vulnerable plaque features and acceptable revascularization outcomes: A three-stroke-center cohort study"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4973-1608","authenticated-orcid":false,"given":"Camilo","family":"Polania-Sandoval","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F.","family":"Meschia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6300-3821","authenticated-orcid":false,"given":"Gyanendra","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Robert D.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard R.","family":"Bendok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M.","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0124-0336","authenticated-orcid":false,"given":"Diego","family":"Sanchez-Calderin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6119-6751","authenticated-orcid":false,"given":"Ekin","family":"Inal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Esquetini-Vernon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7762-9902","authenticated-orcid":false,"given":"W. Christopher","family":"Fox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhwinder J.S.","family":"Sandhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4268-0385","authenticated-orcid":false,"given":"Richard D.","family":"Beegle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-1601","authenticated-orcid":false,"given":"Houssam","family":"Farres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lanzino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1571-6955","authenticated-orcid":false,"given":"Young","family":"Erben","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jvs.2026.08.002_bib1","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S1474-4422(23)00277-6","article-title":"Pragmatic solutions to reduce the global burden of stroke: a World Stroke Organization\u2013Lancet Neurology Commission","volume":"22","author":"Feigin","year":"2023","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.jvs.2026.08.002_bib2","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1161\/STROKEAHA.123.043131","article-title":"Global, regional, and national economic consequences of stroke","volume":"54","author":"Gerstl","year":"2023","journal-title":"Stroke"},{"key":"10.1016\/j.jvs.2026.08.002_bib3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.ejvs.2022.04.011","article-title":"Editor's choice\u2013European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease","volume":"65","author":"Naylor","year":"2023","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"10.1016\/j.jvs.2026.08.002_bib4","doi-asserted-by":"crossref","first-page":"4S","DOI":"10.1016\/j.jvs.2021.04.073","article-title":"Society for Vascular Surgery clinical practice guidelines for management of extracranial cerebrovascular disease","volume":"75","author":"AbuRahma","year":"2022","journal-title":"J Vasc Surg"},{"key":"10.1016\/j.jvs.2026.08.002_bib5","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1056\/NEJM199811123392002","article-title":"Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis","volume":"339","author":"Barnett","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jvs.2026.08.002_bib6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/S0140-6736(03)12228-3","article-title":"Analysis of pooled data from the randomised controlled trials of endarterectomy for symptomatic carotid stenosis","volume":"361","author":"Rothwell","year":"2003","journal-title":"Lancet"},{"key":"10.1016\/j.jvs.2026.08.002_bib7","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1016\/S0140-6736(97)09292-1","article-title":"Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST)","volume":"351","year":"1998","journal-title":"Lancet"},{"key":"10.1016\/j.jvs.2026.08.002_bib8","doi-asserted-by":"crossref","first-page":"3071","DOI":"10.1161\/STROKEAHA.113.002551","article-title":"Carotid plaque MRI and stroke risk: a systematic review and meta-analysis","volume":"44","author":"Gupta","year":"2013","journal-title":"Stroke"},{"key":"10.1016\/j.jvs.2026.08.002_bib9","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1016\/j.jcmg.2022.04.003","article-title":"Carotid plaque characteristics predict recurrent ischemic stroke and TIA: the PARISK (Plaque at RISK) study","volume":"15","author":"van Dam-Nolen","year":"2022","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jvs.2026.08.002_bib10","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S1474-4422(19)30035-3","article-title":"Imaging biomarkers of vulnerable carotid plaques for stroke risk prediction and their potential clinical implications","volume":"18","author":"Saba","year":"2019","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.jvs.2026.08.002_bib11","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.avsg.2024.12.004","article-title":"Intraplaque hemorrhage and plaque ulceration are more likely in patients with symptomatic mild-to-moderate carotid artery stenosis than in symptomatic and asymptomatic high-grade stenosis: a retrospective cohort study","volume":"112","author":"Chen","year":"2025","journal-title":"Ann Vasc Surg"},{"key":"10.1016\/j.jvs.2026.08.002_bib12","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1016\/j.wneu.2018.09.013","article-title":"Efficacy of carotid endarterectomy for mild (<50%) symptomatic carotid stenosis with unstable plaque","volume":"121","author":"Kashiwazaki","year":"2019","journal-title":"World Neurosurg"},{"key":"10.1016\/j.jvs.2026.08.002_bib13","doi-asserted-by":"crossref","first-page":"1930","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.02.032","article-title":"Plaque characteristics of patients with symptomatic mild carotid artery stenosis","volume":"27","author":"Takai","year":"2018","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.1016\/j.jvs.2026.08.002_bib14","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1136\/svn-2021-000939","article-title":"Carotid artery endarterectomy in patients with symptomatic non-stenotic carotid artery disease","volume":"7","author":"Nardi","year":"2022","journal-title":"Stroke Vasc Neurol"},{"key":"10.1016\/j.jvs.2026.08.002_bib15","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.3174\/ajnr.A6613","article-title":"The risk of stroke and TIA in nonstenotic carotid plaques: a systematic review and meta-analysis","volume":"41","author":"Singh","year":"2020","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.jvs.2026.08.002_bib16","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3171\/2024.10.JNS241185","article-title":"Clinical features, radiological findings, and outcome in patients with symptomatic mild carotid stenosis: a MUSIC study","volume":"143","author":"Kashiwazaki","year":"2025","journal-title":"J Neurosurg"},{"key":"10.1016\/j.jvs.2026.08.002_bib17","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/00013644-200312000-00005","article-title":"Carotid artery stenosis: grayscale and Doppler ultrasound diagnosis\u2013Society of Radiologists in Ultrasound consensus conference","volume":"19","author":"Grant","year":"2003","journal-title":"Ultrasound Q"},{"key":"10.1016\/j.jvs.2026.08.002_bib18","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1161\/01.CIR.0000028591.44554.F9","article-title":"Classification of human carotid atherosclerotic lesions with in vivo multicontrast magnetic resonance imaging","volume":"106","author":"Cai","year":"2002","journal-title":"Circulation"},{"key":"10.1016\/j.jvs.2026.08.002_bib19","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.avsg.2023.04.026","article-title":"Systematic review on magnetic resonance angiography with vessel wall imaging for the characterization of symptomatic carotid artery plaque","volume":"95","author":"Gonzalez","year":"2023","journal-title":"Ann Vasc Surg"},{"key":"10.1016\/j.jvs.2026.08.002_bib20","doi-asserted-by":"crossref","first-page":"E9","DOI":"10.3174\/ajnr.A5488","article-title":"Carotid artery wall imaging: perspective and guidelines from the ASNR vessel wall imaging study group and expert consensus recommendations of the American Society of Neuroradiology","volume":"39","author":"Saba","year":"2018","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.jvs.2026.08.002_bib21","doi-asserted-by":"crossref","first-page":"299","DOI":"10.3174\/ajnr.A3209","article-title":"Intracranial atherosclerotic plaque enhancement in patients with ischemic stroke","volume":"34","author":"Skarpathiotakis","year":"2013","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.jvs.2026.08.002_bib22","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1007\/s00234-022-03093-7","article-title":"Utility of high-resolution magnetic resonance vessel wall imaging in differentiating between atherosclerotic plaques, vasculitis, and arterial dissection","volume":"65","author":"Tritanon","year":"2023","journal-title":"Neuroradiology"},{"key":"10.1016\/j.jvs.2026.08.002_bib23","doi-asserted-by":"crossref","first-page":"880","DOI":"10.3174\/ajnr.A7921","article-title":"MR imaging of carotid artery atherosclerosis: updated evidence on high-risk plaque features and emerging trends","volume":"44","author":"Benson","year":"2023","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.jvs.2026.08.002_bib24","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s00062-024-01483-3","article-title":"Non-stenotic carotid plaques and rate of DWI-positive MRI in patients with lower-risk transient or persistent minor neurologic events: DOUBT sub study","volume":"35","author":"Singh","year":"2025","journal-title":"Clin Neuroradiol"},{"key":"10.1016\/j.jvs.2026.08.002_bib25","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2021.719329","article-title":"Non-stenotic carotid plaques in embolic stroke of unknown source","volume":"12","author":"Kamtchum-Tatuene","year":"2021","journal-title":"Front Neurol"},{"key":"10.1016\/j.jvs.2026.08.002_bib26","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jcmg.2012.01.012","article-title":"Prevalence of nonstenosing, complicated atherosclerotic plaques in cryptogenic stroke","volume":"5","author":"Freilinger","year":"2012","journal-title":"JACC Cardiovasc Imaging"},{"key":"10.1016\/j.jvs.2026.08.002_bib27","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1001\/jamaneurol.2020.2658","article-title":"Prevalence of high-risk plaques and risk of stroke in patients with asymptomatic carotid stenosis: a meta-analysis","volume":"77","author":"Kamtchum-Tatuene","year":"2020","journal-title":"JAMA Neurol"},{"key":"10.1016\/j.jvs.2026.08.002_bib28","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.3174\/ajnr.A3399","article-title":"Sex differences of high-risk carotid atherosclerotic plaque with less than 50% stenosis in asymptomatic patients: an in vivo 3T MRI study","volume":"34","author":"Ota","year":"2013","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.1016\/j.jvs.2026.08.002_bib29","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1161\/STROKEAHA.117.017877","article-title":"Age-specific sex differences in magnetic resonance imaging-depicted carotid intraplaque hemorrhage","volume":"48","author":"Singh","year":"2017","journal-title":"Stroke"},{"key":"10.1016\/j.jvs.2026.08.002_bib30","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1161\/STROKEAHA.121.036564","article-title":"Sex differences in plaque composition and morphology among symptomatic patients with mild-to-moderate carotid artery stenosis","volume":"53","author":"van Dam-Nolen","year":"2022","journal-title":"Stroke"}],"container-title":["Journal of Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0741521426015740?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0741521426015740?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T06:37:54Z","timestamp":1788676674000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0741521426015740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":30,"alternative-id":["S0741521426015740"],"URL":"https:\/\/doi.org\/10.1016\/j.jvs.2026.08.002","relation":{},"ISSN":["0741-5214"],"issn-type":[{"value":"0741-5214","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Symptomatic \u226450% carotid artery stenosis is associated with higher rates of vulnerable plaque features and acceptable revascularization outcomes: A three-stroke-center cohort study","name":"articletitle","label":"Article Title"},{"value":"Journal of Vascular Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jvs.2026.08.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Society for Vascular Surgery. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}