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Updated: Aug 15, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Management of asymptomatic carotid stenosis in patients undergoing general and vascular surgical procedures

M Paciaroni1, V Caso, M Acciarresi

  • 1Stroke Unit, University of Perugia, Ospedale Silvestrini, Sant'Andrea delle Fratte, Perugia 06126, Italy. mpaciaroni@libero.it

Journal of Neurology, Neurosurgery, and Psychiatry
|September 20, 2005
PubMed

Insights

Current data do not support routine carotid endarterectomy for asymptomatic carotid stenosis. However, synchronous procedures may benefit select coronary artery disease patients with severe stenosis and low surgical risk.

Area of Science:

  • Vascular Surgery
  • Cardiology
  • Clinical Trials

Background:

  • Asymptomatic carotid stenosis poses a risk for stroke.
  • Optimal management strategies require ongoing investigation.
  • Coronary artery disease patients may have concurrent carotid stenosis.

Purpose of the Study:

  • To evaluate the current evidence for carotid endarterectomy in asymptomatic carotid stenosis.
  • To determine the optimal surgical approach for patients with both coronary artery disease and carotid stenosis.

Main Methods:

  • Review of current available data and clinical guidelines.
  • Analysis of risk stratification for combined procedures.
  • Identification of the need for further randomized clinical trials.

Main Results:

  • Evidence does not support routine carotid endarterectomy for asymptomatic carotid stenosis.
  • Synchronous carotid endarterectomy and coronary artery bypass grafting is a consideration for specific patient groups.
  • Patients with unilateral asymptomatic stenosis >60% or bilateral stenosis >75% and coronary artery disease with surgical risk <3% may benefit.

Conclusions:

  • Current data do not support routine carotid endarterectomy for asymptomatic carotid stenosis.
  • Synchronous procedures should be considered in select patients with coronary artery disease and severe carotid stenosis.
  • Further multicentre, randomized clinical trials are necessary to clarify optimal management strategies.

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