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For patients with symptoms related to a carotid artery stenosis, open surgery remains the first choice

For patients who have symptoms (i.e. transient ischaemic attacks or minor strokes) related to a carotid artery stenosis greater than 50%, interventional treatment of the carotid disease is strongly recommended. The best corrective method today is the classic (open) operation, namely carotid endarterectomy.

This is a clear recommendation (level A) according to the recently published Guidelines of the European Society for Vascular Surgery (ESVS Guidelines. Invasive Treatment for Carotid Stenosis: Indications, Techniques, “European Journal of Vascular & Endovascular Surgery”, [suppl.1] Apr. 2009).

Although carotid angioplasty-stenting seems to have good mid-term results for stroke prevention, this procedure should only be performed on patients at very high surgical risk for the open operation and only at centres with special experience in this procedure. Its long-term results have not been adequately studied yet.