Current Diagnosis and Treatment of Carotid Atherosclerotic Disease

Carotid atherosclerotic disease increases the risk for ischemic stroke and transient ischemic attack and challenges are presented when seeking the appropriate strategy of management. In this review, we will discuss the current diagnostic and treatment approaches of asymptomatic and symptomatic carotid stenosis (SCS). The definition of carotid plaques, staging of stenotic severity, and noninvasive tests including carotid duplex ultrasound, computed tomographic angiography, magnetic resonance angiography, and transcranial Doppler will be summarized. Optimal management for asymptomatic and SCS with medical therapy, carotid artery stenting, or carotid endarterectomy has been controversial and should be judged in specific clinical settings. More clinical data are needed to better understand the correlation of different diagnostic measures and the disease progress and to optimize the treatment approach to improve patient outcomes.