Carotid stenosis: medical and surgical aspects

Medical treatment for carotid disease is similar to the treatment of atherosclerosis, with some recent data suggesting that there is a benefit to an aspirin-dipyridamole combination. CEA has revolutionized the treatment of symptomatic and asymptomatic carotid stenosis. This approach remains the gold standard for the surgical treatment of carotid artery stenosis, against which emerging modalities such as percutaneous carotid stenting should be compared. Higher-risk, asymptomatic patients can safely undergo CEA in high-volume centers for stenosis greater than 80% as defined by ultrasound.