Treatment of Carotid Artery Disease is essential to reduce the risk of stroke.
The treatment depends on the symptoms, the severity of carotid narrowing, the carotid plaque characteristics and your overall physical condition.
It can be lifestyle changes with medical treatment, open surgical repair (carotid endarterectomy) or minimally invasive endovascular repair (carotid stenting).
All three options have a place in contemporary practice and your vascular surgeon will guide you towards the best option.
Treatment is individualized for every patient, taking into account all the aforementioned factors. As a general rule, carotid narrowing less than 50% is only treated medically, irrespective of symptoms.
Manifestation of symptoms (transient ischemic attack or stroke) and carotid narrowing more than 50% requires intervention as there is a high risk for a subsequent ischemic event.
For patients without symptoms but with a high grade stenosis more than 70%, who are active, with a good life expectancy and a low medical risk, intervention is also recommended to prevent a future stroke.
Some scientists currently argue that medical treatment alone may be sufficient for these asymptomatic patients irrespective of the severity of carotid stenosis.
The type of intervention (carotid endarterectomy vs carotid stenting) is another topic of debate, however carotid endarterectomy seems to be safer for symptomatic patients.
A thorough discussion with your vascular surgeon, understanding the risk and alternatives and taking into account your personal opinion will guide the final decision.