{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T19:13:14Z","timestamp":1779304394090,"version":"3.51.4"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T00:00:00Z","timestamp":1620950400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:sec id=\"S0317167121000500_as1\"><jats:title>Background:<\/jats:title><jats:p>Symptomatic carotid near-occlusion is often described as rare. Recent studies have shown that near-occlusions are overlooked, especially near-occlusion without full collapse (with a small but normal-appearing distal internal carotid artery).<\/jats:p><\/jats:sec><jats:sec id=\"S0317167121000500_as2\"><jats:title>Objective:<\/jats:title><jats:p>To assess the prevalence of near-occlusion among symptomatic \u226550% carotid stenosis, incidence of symptomatic near-occlusion, and review the literature.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167121000500_as3\"><jats:title>Methods:<\/jats:title><jats:p>Prospective controlled single-center cross-sectional study. Consecutive cases with symptomatic \u226550% carotid stenosis were examined with computed tomography angiography (CTA). The CTAs were assessed for near-occlusion by two observers. A systematic literature review was performed with emphasis on how study design affects prevalence estimate.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167121000500_as4\"><jats:title>Results:<\/jats:title><jats:p>Totally, 186 patients with symptomatic \u226550% carotid stenosis were included, 34% (<jats:italic>n<\/jats:italic> = 63, 95% CI 27, 41) had near-occlusion. The incidence of symptomatic near-occlusion was 3.4 (95% CI 2.5, 4.2) per 100,000 person-years. Inter-rater \u03ba was 0.71. The average prevalence of near-occlusion among symptomatic \u226550% carotid stenosis was higher in studies with good design (30%, range 27%\u201334%) than studies without good design (9%, range 2%\u201310%).<\/jats:p><\/jats:sec><jats:sec id=\"S0317167121000500_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Near-occlusion is common variant of symptomatic \u226550% carotid stenosis, both in the current study and in all previous studies of good design. 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