Remark: There is limited evidence to guide the optimal treatment of patients with AF and carotid stenosis not requiring revascularisation. Remark: Short-term concomitant antiplatelet therapy (dual or mono) is generally used in the immediate post- revascularization period (eg, 1-3 months). Patients Presenting With ESUS: In North America and Europe, about 1 in 4 ischemic strokes remain of uncertain etiology (ie, not attributable to de nite cardiac embolism, large artery atherosclerosis, or small artery disease), despite adequate investigation, and are termed Because most cryptogenic strokes are embolic, a more recent concept of ESUS has been developed. ESUS has been de ned as ischemic stroke detected by CT or MRI that, after a standardized and adequate diagnostic pathway including brain imaging, echocardiography, cardiac rhythm monitoring for at least 24 h, and imaging of the intracranial and extracranial arteries supplying the affected brain area: is not lacunar (subcortical, < 15 mm diameter); where there is absence of extracranial or intracranial atherosclerosis causing $ 50% luminal stenosis in the arteries supplying the area of ischemia; no major-risk cardioembolic source of embolism (permanent or paroxysmal AF, sustained atrial utter, intra-cardiac thrombus, prosthetic cardiac valve, atrial myxoma or other cardiac tumours, mitral stenosis, recent [< 4 weeks] MI, left ventricular ejection fraction < 30%, valvular vegetations, or infective endocarditis); and no other speci c cause of stroke identi ed (eg, arteritis, dissection, migraine/vasospasm, Thus, ESUS is a subcategory of cryptogenic stroke, accounting for about 1 in 6 ischemic strokes.357 A careful and systematic diagnostic workup in patients with ESUS is needed as there might be important management differences between underlying embolic sources if detected, such as aortic arch atheroma, patent foramen ovale, and paroxysmal AF. This brief section only refers to the latter. 