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Updated: May 3, 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

836

Management of symptomatic carotid disease in 2014

Jason Litsky1, Erik Stilp, Roland Njoh

  • 1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, Fitkin Memorial Pavilion, 789 Howard Avenue 3rd floor, New Haven, CT, 06519, USA, jason.litsky@yale.edu.

Current Cardiology Reports
|January 28, 2014
PubMed

Insights

Symptomatic carotid artery stenosis significantly increases stroke risk. Both carotid endarterectomy (CEA) and carotid artery stenting (CAS) are recommended for high-grade symptomatic lesions, offering superior stroke prevention compared to medical therapy alone.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Cardiovascular Medicine

Background:

  • Extracranial carotid artery stenosis is a major cause of stroke, a leading cause of death.
  • Symptomatic carotid stenosis necessitates urgent evaluation and treatment.
  • Medical therapy for carotid stenosis is evolving.

Purpose of the Study:

  • To review the evidence-based modern management of symptomatic carotid stenosis.
  • To discuss the role of revascularization procedures in stroke prevention.

Main Methods:

  • Review of landmark clinical trials comparing surgical intervention with medical therapy.
  • Analysis of modern investigations evaluating carotid artery stenting (CAS) against carotid endarterectomy (CEA).

Main Results:

  • Carotid endarterectomy (CEA) has demonstrated superiority over medical therapy for stroke prevention in symptomatic lesions.
  • Carotid artery stenting (CAS) has been shown to be non-inferior to CEA.
  • Combined data support a class I recommendation for CEA or CAS in high-grade symptomatic carotid stenosis.

Conclusions:

  • Modern management emphasizes revascularization (CEA or CAS) for high-grade symptomatic carotid stenosis.
  • Treatment decisions should consider the acceptable risk of perioperative events.
  • Evidence supports a shift towards interventional procedures for optimal stroke prevention.

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