Correlation of Intracranial and Extracranial Carotid Atherosclerotic Plaque Characteristics with Ischemic Stroke Recurrence

Motivation: Atherosclerosis affects multiple vascular beds, yet current assessments often focus on individual vessels. A combined evaluation of intracranial and extracranial plaques may improve ischemic stroke recurrence prediction. Goal(s): To assess the predictive value of combined intracranial and extracranial carotid plaque characteristics for ischemic stroke recurrence using high-resolution vessel wall imaging. Approach: In a cohort of 169 patients, clinical data and HR-VWI features of plaques were analyzed and compared between groups with and without ischemic stroke recurrence. Results: The total number of plaques and the coexistence of extracranial carotid and intracranial enhanced plaques were independent risk factors for recurrent stroke, with significant predictive power. Impact: Combined HR-VWI imaging of head and neck arteries can improve stroke recurrence risk assessment, aiding clinicians in identifying high-risk patients and guiding targeted treatments.