{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:31:38Z","timestamp":1787596298977,"version":"build-2736575974"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":23,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Carotid near-occlusion (CNO) is a severe carotid stenosis causing distal internal carotid artery (ICA) diameter reduction, classifiable as with or without full collapse. Whether full collapse confers an especially high short-term recurrent stroke risk is debated, and no prior pooled analysis has quantified the ultra-early (0\u20132\u00a0day) risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Pooled individual patient data from 3 prospective cohort studies (TransAtlantic Carotid Near-Occlusion Study [TACNOS], UCC [Ume\u00e5 Carotid Cohort], CAsi Oclusi\u00f3n Sintom\u00e1tica [CAOS]). The primary outcome was ipsilateral ischaemic stroke or retinal infarction within 90\u00a0days, censored at revascularisation. Full collapse was defined by visual appearance and by measurement (distal ICA \u2264\u20092.0\u00a0mm and\/or ICA ratio\u00a0\u2264\u00a00.42). Cox regression and pre-specified sensitivity analyses addressing ascertainment bias and informative censoring were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 360 patients with symptomatic CNO were included. The 90-day recurrent stroke risk was 16.4% (95% CI, 11.7%\u201321.1%), with 5.9% within the first 2\u00a0days. Per-cohort rates differed markedly (TACNOS 23.9%, UCC 22.3%, CAOS 8.1%; I2\u00a0=\u00a077%, P\u00a0=\u00a0.012). By visual appearance (n\u00a0=\u00a0333), 90-day stroke risk did not differ by collapse status (adjHR 1.5; 95% CI, 0.8\u20132.9). By measurement (n\u00a0=\u00a0219), full collapse was associated with higher stroke risk (adjHR 2.0; 95% CI, 1.0\u20133.9). For both definitions, full collapse strongly predicted 0\u20132\u00a0day recurrence (adjHR 4.0; 95% CI, 1.5\u201310.5 and adjHR 4.8; 95% CI, 1.8\u201312.8). Full collapse combined with TIA identified a subgroup with 90-day stroke risk of 37.8% (by appearance) and 50.4% (by measurement).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Findings should be interpreted in the context of substantial between-study heterogeneity and informative censoring; sensitivity analyses confirmed the robustness of the estimates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Carotid near-occlusion with full collapse carries a markedly elevated risk of stroke recurrence within 48\u00a0h, supporting dedicated trials of urgent revascularisation strategies. In exploratory analysis, presentation with TIA appeared to identify a particularly high-risk subgroup, a hypothesis-generating observation that requires independent validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/aakag100","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:05:39Z","timestamp":1787594739000},"source":"Crossref","is-referenced-by-count":0,"title":["Short-term risk of recurrent stroke in symptomatic carotid near-occlusion: pooled analysis of three cohort studies"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0090-8807","authenticated-orcid":false,"given":"Andr\u00e9s","family":"Garc\u00eda-Pastor","sequence":"first","affiliation":[{"name":"Vascular Neurology Section and Stroke Centre, Department of Neurology, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IISGM) , Madrid 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