[Asymptomatic carotid stenosis: which preoperative diagnosis is necessary and adequate?]

Operative correction of asymptomatic ICA stenosis requires only CCT and intraarterial DSA of all the common noninvasive procedures. Multiple vessel disease, however, must also be examined by quantitative cerebral blood flow measurements to determine the autoregulation reserve capacity; this can be done by transcranial Doppler plus CO2 provocation or rCBF with carboanhydrase inhibitor. CCT or NMRI seems necessary in any case. Detailed cardiac examination is absolutely necessary in all carotid patients.