Current concepts in the management of carotid stenosis

Several large randomized clinical trials in North America and Europe concluded over a decade ago that carotid endarterectomy plus medical management was significantly better than medical management alone for stroke prevention in either symptomatic or asymptomatic patients with severe carotid stenosis. Percutaneous carotid angioplasty now represents another treatment option that currently seems most appropriate either in the context of prospectively randomized trials or for patients who are at a higher than average risk for conventional surgical treatment.