Best medical treatment for carotid stenosis

Abstract

Several guidelines recommend carotid endarterectomy and percutaneous transluminal angioplasty with stent-ing for patients with carotid artery stenosis. However, considering that such evidence was established around 20 years ago and medical therapy (pharmacotherapy) has made great strides since then, it is essential to perform the best medical treatment for carotid stenosis patients. Statins are often used to treat carotid stenosis to suppress intima-media complex thickening and stabilize carotid plaque. High-dose statins were proven to be protective against recurrent stroke. Antiplatelet therapy is important for protecting against microemboli embolization from the rupture and erosion of the carotid plaque to the brain. Although a single antiplatelet agent is routinely recommended for the prevention of recurrent stroke, the effects of dual therapy were reported during the subacute stage (ex. the initial 3 months after onset) for carotid stenosis patients.