This paper shows that carotid stenosis is not a rare incidental finding but a patterned disease concentrated in stroke, TIA, and clearly defined high-risk groups—while broad screening in low-yield populations adds little. It is worth reading because it maps where carotid imaging truly matters and why future risk assessment may need to move beyond percent narrowing toward plaque vulnerability.
Abstract: The aim of this paper is to systematically synthesize the reported prevalence of carotid stenosis across various patient populations and clinical scenarios, identifying key demographic and clinical associations. The review utilises 120 studies. Across the mapped evidence, significant carotid stenosis (≥50%) shows substantial prevalence in cerebrovascular presentations, ranging from 6.9% to 18.7% in acute ischemic stroke cohorts and reaching 15.8% in young adults with recent TIA or stroke. The evidence consistently indicates strong risk gradients by age/sex and comorbidity, with notably higher prevalence in selected high-risk groups such as isolated systolic hypertension (25%) and maintenance hemodialysis (9.4%), while some preoperative or screening contexts show low yield (e.g., 1.47% for >70% stenosis in kidney transplant candidates and 2.25% in isolated valve surgery patients). Beyond luminal narrowing, multiple studies highlight that non-stenotic but high-risk plaque features are common in symptomatic populations and may represent an under-recognized embolic substrate, supporting a shift toward plaque-based risk stratification alongside stenosis grading. Clinically, these patterns support targeted imaging strategies focused on symptomatic patients and clearly defined high-risk subgroups rather than broad low-prevalence screening. Future research should prioritize prospective, standardized studies that harmonize stenosis definitions and imaging criteria and directly compare the prognostic value of high-risk plaque characteristics versus percent stenosis for stroke risk prediction.
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Total Abstracts/Papers: 1360
Downloaded Abstracts/Papers: 1360
Included original and non-original Abstracts/Papers (all): 839
Included original Abstracts/Papers (OSMA vote counting by direction of effect): 755
Reference Index (links used in paper): 112
Total participants (topic deduplicated ΣN): 4503432
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Reference Index (112)
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