How is carotid artery stenosis treated?

After diagnosing carotid artery stenosis, the first step is to address the underlying causes—such as controlling blood pressure, blood glucose, and lipid levels; achieving and maintaining a healthy weight through weight loss; engaging in moderate physical activity; and quitting smoking and limiting alcohol consumption. Statins may be prescribed to regulate lipid levels and inhibit plaque progression, while aspirin can be used to suppress platelet aggregation and reduce the risk of thrombosis.For moderate-to-severe carotid stenosis (>60%), surgical intervention is indicated. Carotid endarterectomy (CEA) is the preferred procedure: it involves surgically opening the affected artery, removing the atherosclerotic plaque, and restoring normal blood flow. CEA boasts high procedural success rates and superior long-term outcomes.

In patients who are not suitable candidates for surgery, carotid artery stenting (CAS) is an alternative minimally invasive option that avoids open surgery. CAS effectively improves cerebral perfusion and reduces thrombotic risk.