Carotid Artery Disease Treatment Techniques
Summary
Carotid artery disease arises from atherosclerotic narrowing of the carotid bifurcation, posing a risk of cerebral ischaemia and stroke. Treatment strategies centre on reducing stroke incidence through medical management and mechanical revascularisation. Optimised medical therapy encompasses antiplatelet agents, lipid-lowering drugs and stringent control of blood pressure and glycaemia, which together stabilise plaques and limit progression. Surgical removal of plaque via carotid endarterectomy restores luminal diameter but carries procedural risks, including perioperative stroke. Endovascular carotid artery stenting offers a less invasive alternative, employing intraluminal scaffolds to widen stenosed segments, though susceptibility to embolic complications has been a concern. Patient selection hinges on symptomatic status, degree of stenosis and individual surgical risk. Imaging modalities such as duplex ultrasound, CT angiography and magnetic resonance angiography underpin decision-making by delineating plaque morphology and haemodynamic significance. Emerging risk models integrate plaque characteristics, clinical factors and novel biomarkers to tailor intervention thresholds. In concert, these approaches strive for a balance between the durability of revascularisation and the safety of medical regimens, with global practice guided by evolving evidence.
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Carotid Artery Disease Treatment Techniques publication trend
The graph below shows the total number of articles in carotid artery disease treatment techniques across all publications each year (not limited to Nature Index journals).
Technical terms
Carotid endarterectomy: Surgical removal of atherosclerotic plaque from the carotid artery to restore vessel lumen and reduce stroke risk.
Carotid artery stenting: Endovascular placement of a metal scaffold within the carotid artery to dilate stenosed segments and maintain patency.
Optimised medical therapy: A comprehensive pharmacological regimen including antiplatelet, lipid-lowering and antihypertensive agents to stabilise plaques and prevent stroke.
Asymptomatic carotid stenosis: Narrowing of the carotid artery by at least 50% in patients without recent stroke or transient ischaemic attack.
Vulnerable plaque: An atherosclerotic lesion characterised by a large lipid core, thin fibrous cap or intraplaque haemorrhage, predisposed to rupture.
References
- Optimised medical therapy alone versus optimised medical therapy plus revascularisation for asymptomatic or low-to-intermediate risk symptomatic carotid stenosis (ECST-2): 2-year interim results of a multicentre randomised trial. The Lancet Neurology (2025).
- Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy. The Lancet (2021).
- Risk of stroke in relation to degree of asymptomatic carotid stenosis: a population-based cohort study, systematic review, and meta-analysis. The Lancet Neurology (2021).
- Imaging modalities to diagnose carotid artery stenosis: progress and prospect. BioMedical Engineering OnLine (2019).
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