<unk>  is used to reduce the risk of strokes caused by carotid artery stenosis over time. Carotid stenosis can either have symptoms (ie, be symptomatic), or be found by a doctor in the absence symptoms (asymptomatic) - and the risk-reduction from endarterectomy is greater for symptomatic than asymptomatic patients. Carotid endartectomy itself can cause strokes, so to be of benefit in preventing strokes over time, the risks for combined 30-day mortality and stroke risk following surgery should be < 3% for asymptomatic people and ≤ 6% for symptomatic people. The carotid artery is the large vertical artery in red. The blood supply to the common carotid artery starts at the arch of the aorta (left) or the subclavian artery (right). The common carotid artery divides into the internal carotid artery and the external carotid artery. Plaque often builds up at that division, and a<unk>  cuts open the artery and removes the plaque.<unk>  does not treat symptoms of prior strokes. It is controversial if<unk>  can improve cognitive function in some patients. Symptomatic Symptomatic people have had either a stroke or transient ischemic attack. In symptomatic patients with a 70–99% stenosis, for every six people treated, one major stroke would be prevented at two years (i.e., a number needed to treat of six). Unlike asymptomatic patients, symptomatic people with mild carotid stenosis (50–69%) still benefit from endarterectomy, albeit to a lesser degree, with a number needed to treat of 22 at five years. In addition, co-morbidity adversely affects the outcome: people with multiple medical problems have a higher post-operative mortality rate and hence benefit less from the procedure. For maximum benefit people should be operated on soon after a stroke or transient ischemic attack, preferably within the first 2 weeks. Asymptomatic Asymptomatic people have narrowing of their carotid arteries, but have not experienced a transient ischemic attack or stroke. The annual risk of stroke in patients with asymptomatic carotid disease is between 1% and 2%, although some patients are considered to be at higher risk, such as those with ulcerated plaques. This low rate of stroke means that there is less potential stroke risk-reduction from endarterectomy for asymptomatic patients relative to symptomatic patients. However,<unk>  plus treatment with a statin medicine and anti-platelet therapy does reduces stroke risk further than medication alone in the five years following surgery for asymptomatic patients with severe carotid stenosis (80-99%).
Carotid endarterectomy
Carotid stenting
Endarterectomy
Angioplasty
Thrombectomy
Compression stockings
Electrothermal bipolar vessel sealing
Pulmonary thromboendarterectomy