Carotid endarterectomy: The procedure of choice for carotid stenosis

Abstract

Ischemic stroke is the commonest cause of neurological morbidity and mortality. Carotid endarterectomy has been shown to be beneficial in preventing ischemic strokes in patients with significant stenosis of the carotid artery, both in symptomatic and asymptomatic patients. Carotid artery stenting has been proposed as an alternative to CEA for this population. This paper reviews the available literature on carotid endarterectomy comparing it to the best medical therapy and carotid artery stenting in the prevention of ischemic strokes in patients with carotid stenosis. The use of newer imaging techniques and tools to redefine the existing idea of “asymptomatic” stenosis and post procedural strokes has also been reviewed. We present a concise review of existing data that shows unequivocally that endarterectomy still remains superior to stenting and best medical therapy as of now.

Keywords

• carotid artery
• endarterectomy
• revascularization
• stroke