How to treat an asymptomatic carotid stenosis? The view of the neurologist

SummaryThe optimal treatment strategy for patients with asymptomatic carotid artery stenosis (ACS) is still a matter of debate. Based on a simplistic view, all stenosed vessels should be cleaned, and the earlier the better. Due to the improvements of medical management in patients with high-grade ACS, there is uncertainty as how to best manage these patients. Consequently, the cost-effectiveness of CEA in patients with ACS has been questioned. Therefore, the question arises how best medical treatment changes the risk of stroke in patients with ACS. This overview discussed the therapeutic options for ACS from a neurological point of view.