Related Experiment Video

Updated: Nov 11, 2025

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

284

Epidemiology of atherosclerotic carotid artery disease

Shernaz Dossabhoy1, Shipra Arya1

  • 1Division of Vascular Surgery, Department of Surgery, Stanford University School of Medicine, 300 Pasteur Drive, Alway M121-P, MC 5639, Stanford, CA 94305.

Seminars in Vascular Surgery
|March 24, 2021
PubMed

Insights

Atherosclerotic carotid artery disease, a major stroke cause, disproportionately affects women and Black patients. Management strategies are evolving, especially for asymptomatic cases, with ongoing trials comparing medical versus surgical interventions.

Area of Science:

  • Vascular Medicine and Neurology
  • Public Health and Epidemiology
  • Surgical and Interventional Cardiology

Background:

  • Atherosclerotic carotid artery disease is a primary global cause of stroke, with prevalence increasing with age.
  • While more common in men and White/Native-American populations, outcomes are poorer for women and Black patients, suggesting multifactorial disparities.
  • Current guidelines do not recommend routine screening for carotid stenosis in the general adult population due to its low prevalence (3%).

Purpose of the Study:

  • To review the current understanding of atherosclerotic carotid artery disease, including prevalence, risk factors, and disparities.
  • To discuss the established benefits of surgical intervention for symptomatic patients and the ongoing debate regarding asymptomatic patients.
  • To highlight the need for future research into comprehensive care models and patient-reported outcomes.

Main Methods:

  • Review of existing literature and randomized clinical trials on carotid artery disease management.
  • Analysis of epidemiological data regarding prevalence and demographic disparities.
  • Discussion of current treatment controversies and future research directions.

Main Results:

  • Symptomatic carotid stenosis benefits from stroke risk reduction via surgery (carotid endarterectomy or stenting).
  • Management for asymptomatic carotid stenosis is controversial, with modern medical therapies showing comparable results to surgery.
  • Carotid surgery is contraindicated in asymptomatic patients with limited life expectancy.

Conclusions:

  • Further randomized clinical trials are crucial to definitively address the optimal management of asymptomatic carotid stenosis.
  • Future research should focus on developing comprehensive care models and incorporating patient-reported outcomes to enhance quality of care.
  • Addressing socioeconomic factors and provider bias is essential to mitigate observed outcome disparities in carotid artery disease.

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