{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:45:53Z","timestamp":1782992753010,"version":"3.54.5"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Symptomatic nonstenotic (&lt;50% stenosis) carotid disease in the presence of high\u2010risk plaque features is a potential cause of ischemic stroke. We assessed stroke risk associated with symptomatic nonstenotic carotid disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This cross\u2010sectional secondary analysis of the AcT (Alteplase Compared to Tenecteplase) randomized controlled trial evaluated baseline computed tomography angiograms for degree of internal carotid artery stenosis, plaque features and the presence of intraluminal thrombi, webs, dissection, and rim sign. Stroke location was evaluated on 24\u2010hour follow\u2010up imaging. At a carotid level, mixed\u2010effects logistic regression models adjusted for age and sex, with patient identity as a random effect, examined associations between \u201cconcordant stroke\u201d (ipsilateral acute stroke in the internal carotid artery territory) and symptomatic nonstenotic carotid disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Of 1577 patients enrolled, 1407 (89.2%) with interpretable imaging were included: 329 (23.4%) had no carotid disease, 869 (61.8%) had nonstenotic carotid disease, and 209 (14.9%) had stenotic (\u226550%) carotid disease in either the left or right internal carotid artery. Median age was 73\u2009years (interquartile range, 63\u201383), with 48% female patients. Among 2519 (89.5%) internal carotid arteries with nonstenotic disease, 689 (27.4%) concordant strokes were identified. Intraluminal thrombi, carotid webs, carotid dissections, and carotid rim sign were significantly associated with concordant stroke (adjusted odds ratio, 8.11 [95% CI, 1.60\u201341.08]; adjusted odds ratio, 3.58 [95% CI, 1.53\u20138.35]; adjusted odds ratio, 6.77 [95% CI, 1.72\u201326.75]; and adjusted odds ratio, 3.17 [95% CI, 1.39\u20137.23], respectively). Results remained unchanged after excluding patients with atrial fibrillation and lacunar infarctions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Features other than the degree of stenosis should be considered when evaluating patients with carotid disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042821","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:40:58Z","timestamp":1768390858000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Ipsilateral Stroke and Nonstenotic (&lt;50%) Carotid Disease: Secondary Analysis From the AcT Trial"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7263-8474","authenticated-orcid":false,"given":"Katrina Hannah 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Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke","author":"Heart and Stroke Foundation of Canada","year":"2020","unstructured":"Heart and Stroke Foundation of Canada . Management of Extracranial Carotid Disease and Intracranial Atherosclerosis [online]. Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke. 7th ed. Heart and Stroke Foundation of Canada; 2020. 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