[Interventional management of carotid stenosis--status 2007]

Only symptomatic patients with severe carotid stenosis should be considered for interventional management. Treatment should be initiated within weeks after the first neurological symptom. To save time, diagnostic investigation should be feasible the first time patients are seen. Open surgery is evidence-based and first choice. Carotid stenting has not proven superior to carotid endarterectomy. Until further evidence is provided, CAS should be reserved for patients with high surgical risks. All patients, symptomatic as well as asymptomatic, should undergo aggressive risk factor modification.