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The future in the management of patients with asymptomatic carotid artery stenosis.

International angiology : a journal of the International Union of Angiology 2025
Kosmas I Paraskevas, Sherif A Sultan, Ali F Aburahma, Wesley S Moore, Matthew Blecha, Piotr Myrcha, Clark J Zeebregts, Ales Blinc, Alun H Davies, Mario D'Oria, Mauro Gargiulo, Pavel Poredos, Alexei Svetlikov, Bruce A Perler, Seemant Chaturvedi, Gemmi Sufali, Luca Saba, Jens Eldrup-Jorgensen, Sean P Lyden, Carlo Setacci, Vincenzo DI Lazzaro, Tilman Reiff, Agnieszka Sawicka, Christos D Liapis, Gaetano Lanza, Gaia Spinetti, Antonino Bruno, Andrew N Nicolaides, Ankur Thapar, Maarten Uyttenboogaart, Arkadiusz Jawien, Dimitri P Mikhailidis, Francesco Spinelli, Francesco Stilo, Piotr Musialek, Victor Gurevich, Mauro Silvestrini, Young M Erben, Peter A Schneider, Gregory Y Lip, Christopher J White, Alan Dardik, James F Meschia, Mahmoud B Malas, Peter Gloviczki, Marc L Schermerhorn, Armando Mansilha

Summary

This review discussed emerging technological advances for diagnosing and managing asymptomatic carotid artery stenosis, including artificial intelligence-based imaging, biomarker analysis, and improved plaque characterization tools. The article examined how these advances may help personalize treatment decisions for patients at risk of stroke.

Models
Human

INTRODUCTION: The optimal management of patients with asymptomatic (AsxCS) and symptomatic carotid stenosis (SxCS) is still debatable. The present article will discuss emerging technological advances for the diagnosis and management of patients with AsxCS. EVIDENCE ACQUISITION: PubMed/MedLine was searched until December 31, 2024 for studies in English discussing emerging technological advances in the diagnosis and management of patients with AsxCS. EVIDENCE SYNTHESIS: Several technological advances have recently been reported, among others, nanoplastics and microplastics, artificial intelligence and machine learning in predictive analytics for stroke prevention, digital twins for personalized monitoring, electronic tattoos for continuous non-invasive monitoring, stroke risk prediction through plaque morphology and late-phase contrast-enhanced ultrasound. A brief overview of each technological advance is presented and discussed. CONCLUSIONS: The technological advances discussed in the present article will aid the early diagnosis of AsxCS as well as the individualized optimal management of patients with AsxCS.

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