Carotid Artery Disease

Treatment

Mayo Clinic physicians evaluate patients for narrowing of their carotid arteries to determine if they are candidates for carotid endarterectomy or carotid angioplasty and stenting, a less invasive procedure.

When Should Carotid Artery Disease Be Treated?

Asymptomatic Carotid Disease

A recent study involving more than 1,600 patients suggests that if the carotid artery stenosis has never caused any symptoms, the artery should be repaired when the diameter of the artery narrows by 60 percent or more.

Before undergoing surgical repair of a narrowed carotid artery, patients may wish to consider:

• The surgeon performing the operation must be experienced.
• The patient's general health should be good, with no significant illness that might otherwise increase the risks of the surgery. Each patient should be evaluated carefully before making a decision to operate.

Symptomatic Carotid Disease

If the artery is narrowed by more than 70 percent and has caused symptoms, surgery is usually recommended to prevent further symptoms or stroke. If no surgery is done, despite the symptoms and narrowing of the artery, the chance of a stroke is about 26 percent over two years. This risk is reduced to 9 percent if the artery is repaired. If the artery is narrowed by more than 50 percent but less than 70 percent, there still may be a benefit to repairing the artery to prevent future problems.

Artery Narrowed Less Than 50 Percent

There is no proven benefit to operate on an artery that is narrowed less than 50 percent. In that case, medical treatment is usually just as effective as surgery. Medical treatment may consist of taking one adult aspirin a day and controlling risk factors. However, each patient must be carefully evaluated, and an individual treatment plan should be developed based on input from a team of physicians experienced in treating carotid artery disease, from the patient and from the patient's family.