Supraaortic vessels: a clinician's point of view

Stroke has been recognized as the third leading cause of death in the Western World, and more than 80% of all ischemic events is caused by arteriosclerosis affecting the extracranial arteries, especially the carotid bifurcation. Carotid endarterectomy (CEA) is the gold standard for preventing stroke in symptomatic and asymptomatic patients with significant carotid stenosis, when performed in centers with low complication rates (less than 3%). Recently, the carotid artery stenting (CAS) has been proposed as an alternative procedure, although its safety compared to conventional CEA is not fully documented yet. For both techniques, an accurate diagnosis by various imaging techniques is very important regarding the risk of serious complications following surgical intervention.