Overview

• The MUSIC study found that 81% of patients with symptomatic mild carotid stenosis had unstable plaques, with 59.5% exhibiting intraplaque hemorrhage (IPH).
• Patients with IPH faced significantly higher risks of recurrent strokes, even when receiving best medical therapy.
• Carotid endarterectomy (CEA) reduced the two-year ischemic stroke rate to 1.7%, compared to 15.1% in patients managed with medical therapy alone.
• The findings challenge existing guidelines that reserve CEA for moderate to severe stenosis, advocating for advanced imaging to assess plaque composition.
• Researchers call for further studies to validate these results across diverse populations and explore adjunctive therapies targeting plaque stabilization.