Vascular Imaging COR LOE New, Revised, or Unchanged For patients with nondisabling (mRS score 0 2) AIS in the carotid territory who are candidates for CEA or stenting, noninvasive imaging of the cervical carotid arteries should be performed routinely within 24 hours of admission. I B-NR New recommendation. Past data have indicated that the risk of recurrent stroke caused by symptomatic carotid stenosis is highest early after the initial event.325 329 Although there is evidence that early or emergency revascularization via either CEA or carotid angioplasty and stenting may be safe in selected cases,330 332 there are no high-quality prospective data supporting early versus late carotid revascularization in all cases.333 In cases of nondisabling stroke, a meta-analysis by De Rango demonstrates high rates of complications when treated <48 hours after the initial event and no difference in risks when treated between 0 and 7 days and 0 and 15 days. Revascularization between 48 hours and 7 days after initial stroke is supported by the data in cases of nondisabling stroke (mRS score 0 2).334 Imaging within 24 hours of admission is feasible and recommended to facilitate CEA/carotid angioplasty and stenting in eligible patients in the 48- to 72-hour window. See Table LXXVIII in online Data Supplement 1. For prevention of recurrent stroke, the use of intracranial vessel imaging is reasonable in some patients with AIS to provide additional information to guide selection of appropriate secondary stroke prevention treatments. IIa C-EO New recommendation. An extensive literature search did not yield adequate data to identify subgroups of patients with AIS for whom information obtained from intracranial vessel imaging will lead to improved outcome. There is no RCT evidence that patients with AIS and symptomatic intracranial stenosis should be treated differently from other patients with ischemic stroke of presumed atherosclerotic cause. 