Stenosis of the carotid bifurcation: Stenting or surgery?

Systematic medical treatment and control of risk factors ore essential in all cases. The rate of stroke or death for asymptomatic carotid artery stenosis (>60%) is 2% per year. Symptomatic carotid artery stenosis (>50%) must be treated without delay (10% risk of recurrence in the first two weeks). In 2008, carotid endarterectomy is still the gold standard for treatment of patients with severe carotid stenosis. Carotid stenting is an alternative for patients with inaccessible lesions or at high risk for surgery (French recommendations 2007). A multidisciplinary approach is recommended. Successful endovascular treatment requires careful patient selection and an operator and team with extensive experience.