Medical, surgical, and interventional treatment for carotid artery disease.

Internal carotid artery atherosclerosis is a major cause of ischemic stroke. Medical, surgical, and interventional options are available for stroke prevention in patients with carotid artery stenosis. Optimal management of the patient depends to a great degree on whether the individual is symptomatic or asymptomatic. Coexisting medical morbidities also greatly influence treatment decisions regarding carotid endarterectomy. This review highlights the current status of antiplatelet therapy and warfarin for stroke prevention in patients with carotid stenosis. The appropriate role of carotid endarterectomy for symptomatic and asymptomatic patients is also discussed. Finally, the current status of carotid angioplasty and stenting is outlined.