Symptomatic Carotid Outcomes Registry

This study will only be evaluating clinical care and no interventions will be done specifically for this research.

• Informed consent from patient or legally authorized representative.
• Participant survey/questionnaire completion at baseline, 6 and 12 months after enrollment
• All data collected will be entered into a secure research data registry created for this study.

Inclusion criteria

• Age ≥40 years plus stroke or TIA ipsilateral to 50-99% ICA stenosis

In addition, patients must have at least one clinical or radiologic marker of reduced stroke risk

Clinical Reduced Stroke RISK:

• Retinal ischemia only (amaurosis fugax, branch retinal artery occlusion (BRAO), central retinal artery occlusion (CRAO)
• Female sex
• Most recent stroke or TIA >1 week ago

Radiologic Reduced Stroke RISK:

• Transcranial Doppler (TCD) study demonstrating lack of microembolic signals
• Cross-sectional MRI plaque imaging demonstrating absence of intraplaque hemorrhage
• For patients with TIA: brain MRI shows no DWI lesion

Exclusion criteria

Atrial fibrillation or other high-risk sources of cardiac embolism unless it is device detected AF only or duration <6 minutes

Alcohol and substance abuse within the prior 24 months

Clinically significant bleeding diathesis (platelet count <100K, prothrombin time >14 seconds)

Clear indication for therapeutic anticoagulation (for example, DVT or pulmonary embolism within past 3 months)

Left ventricular ejection fraction <20%

Known allergy or intolerance to aspirin or clopidogrel

Life expectancy less than 12 months

Moderate/severe dementia (Mini-mental or MOCA score <22

Modified Rankin score of >4

Nonatherosclerotic cause of carotid stenosis

Most recent symptomatic event >180 days from the time of enrollment

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