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Introduction Stroke is a leading cause of death and disability worldwide, with up to 30% of ischemic strokes classified as cryptogenic under TOAST criteria (Goyal et al. 2020). Embolic strokes of undetermined source (ESUS) refine this definition, with 27–51% of cases potentially linked to symptomatic non-stenotic carotid disease (SyNC) featuring plaques causing <50% stenosis (Schaller et al. 2024). Morphological features, including intraplaque hemorrhage and ulcerations, have been associated with stroke risk, particularly in ESUS patients, where these plaques are frequently found ipsilateral to the stroke (Ospel et al. 2023). SyNC may therefore represent an overlooked contributor to stroke etiology.Aim of Study To analyse the clinical safety and efficacy of the CARESTO® heal Stent within standard clinical routine for the treatment of patients with SyNC and with high risk plaque features for stroke recurrence compared to medication treatment alone with respect to the mid- and long-term clinical outcomes.Method The study includes patients who experienced a stroke or retinal ischemia within the past two weeks and are deemed at high risk of recurrence due to SyNC. Eligible patients who meet all inclusion and exclusion criteria and provide consent are randomized during their hospital stay to prevent bias and ensure reliable results.Results We are starting enrolment into this randomized controlled trial. To the best of our knowledge this is the first randomized trial for patients with SyNC.Conclusion CARESTAR study has the potential to provide clinical evidence to inform and optimize therapeutic strategies for managing SyNC addressing a critical gap in stroke prevention.Conflict of Interest Yes Consultant, Acadis