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With the aging of the general population and the availability of noninvasive imaging studies, carotid artery stenosis is a disease commonly seen in general medical practice. Differentiation between symptomatic and asymptomatic disease is critical to the treatment course because the natural history differs markedly between them. Antiplatelet therapy and aggressive treatment of vascular risk factors are the mainstays of medical therapy.

Class I evidence shows that carotid endarterectomy (CEA) is effective in preventing ipsilateral ischemic events in patients with symptomatic moderate- and high-grade stenosis. The procedure is also effective in selected patients with asymptomatic stenosis, but the benefit is marginal. In the past decade, carotid angioplasty and stenting has been proposed as a valid alternative to CEA. Currently, it is unclear whether carotid angioplasty and stenting is as safe as CEA in patients with carotid artery stenosis who need invasive treatment.

You may not have any symptoms of carotid artery disease. Plaque builds up in the carotid arteries over time with no warning signs until you have a transient ischemic attack(TIA) or a stroke.

Signs of a stroke may include:

  • Sudden loss of vision, blurred vision, or difficulty in seeing out of one or both eyes
  • Weakness, tingling, or numbness on one side of the face, one side of the body, or in one arm or leg
  • Sudden difficulty in walking, loss of balance, lack of coordination
  • Sudden dizziness and/or confusion
  • Difficulty speaking (called aphasia)
  • Confusion
  • Sudden severe headache
  • Problems with memory
  • Difficulty swallowing (called dysphagia)

Treatment Options

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