Symptomatic and asymptomatic carotid stenosis: Just when we thought we had all the answers

P. C. Gates*, B. Chambers, B. Yan, W. Chong, M. Denton

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)


The management of symptomatic and asymptomatic carotid stenosis has been a hotly debated topic for decades. The publication of four randomized controlled trials of carotid endarterectomy has clarified many of the issues. Patients with symptomatic carotid stenosis >70% benefit most with an absolute risk reduction of 17% over 2 years with numbers needed to treat of 3-6, whereas in patients with asymptomatic carotid stenosis >60%, the absolute risk reduction is 1% per annum (numbers needed to treat = 14-17). There is doubt about the benefit in women >70 years of age with asymptomatic stenosis. Carotid angioplasty and stenting is in its infancy and may one day supplant carotid endarterectomy as the treatment of choice; however, currently indications for this procedure include participation in randomized controlled trials, surgically inaccessible stenosis, in patients with combined symptomatic carotid and symptomatic coronary artery disease or in patients with severe co-morbidities that preclude formal carotid endarterectomy.

Original languageEnglish
Pages (from-to)445-451
Number of pages7
JournalInternal Medicine Journal
Issue number7
Publication statusPublished - Jul 2006


  • Asymptomatic
  • Carotid endarterectomy
  • Carotid stenosis
  • Carotid stenting
  • Symptomatic


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