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Management of Large Artery Atherosclerosis

Ashley M Wabnitz

    Continuum (Minneapolis, Minn.)
    |June 3, 2026
    PubMed

    Insights

    Large artery atherosclerosis increases stroke risk. Aggressive management of risk factors, antithrombotic therapy, and careful patient selection for revascularization are key to preventing recurrent ischemic strokes.

    Area of Science:

    • Neurology
    • Cardiovascular Medicine
    • Vascular Surgery

    Background:

    • Large artery atherosclerosis is a primary cause of ischemic stroke and transient ischemic attack.
    • It represents a significant risk factor for recurrent strokes, particularly in an aging population with prevalent risk factors.
    • The incidence of stroke due to atherosclerosis is projected to rise.

    Purpose of the Study:

    • To provide clinicians with current best practices for diagnosing and managing large artery atherosclerosis.
    • To outline strategies for secondary stroke prevention in patients with this condition.

    Main Methods:

    • Review of current medical literature and clinical guidelines.
    • Synthesis of evidence-based recommendations for risk factor management, antithrombotic therapy, and revascularization.

    Main Results:

    • Aggressive management of hypertension and hyperlipidemia is crucial.
    • Dual antithrombotic therapy is recommended for an increasing number of patients.
    • The role of revascularization, especially for asymptomatic carotid disease, is under ongoing investigation.

    Conclusions:

    • Preventing ischemic stroke hinges on aggressive risk factor control.
    • Appropriate selection of antithrombotic agents is essential for secondary prevention.
    • Careful patient selection for revascularization procedures is critical in the current management landscape.
    Abstract

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