[Carotid stenosis: is the distinction between "symptomatic" and "asymptomatic" obsolete?]

Carotid stenosis is common, especially among patients with vascular risk factors. The usual distinction between "symptomatic" and "asymptomatic" corresponds to older studies on the surgical vs. conservative treatment and to newer studies on interventional treatment (angioplasty with/without stent vs. surgery). However, both forms only describe different stages of activity of the same disease. They are markers of a systemic atherosclerosis, which results in a high risk of cardiovascular events in particular. All patients with carotid stenosis profit from regular clinical and duplexsonographic follow-up-studies of the brain arteries, cardiovascular assessment and good control of all vascular risk factors. Patients with carotid stenosis may profit from carotid intervention, if this takes place shortly after onset of associated cerebral ischemia and/or if there is a favorable benefit-risk ratio.