Asymptomatic Carotid Artery Stenosis: Revascularization

In patients with carotid stenosis, the most common cause of stroke is atheroembolization, and the risk is strongly related to stenosis severity and symptomatic status (stroke or transient ischemic attack within 6months). Carotid revascularization by carotid endarterectomy (CEA) or carotid artery stenting (CAS) result in plaque “passivation” by lumen enlargement, plaque removal, or plaque coverage with subsequent endothelialization. While there is considerable circumstantial evidence linking a decrease in the risk of stroke to the use of “optimal medical therapy (OMT)”, the components of OMT have not been defined, and such therapy has not been rigorously evaluated in any randomized clinical trial (RCT) compared with revascularization.
Source: Progress in Cardiovascular Diseases - Category: Cardiology Authors: Source Type: research