What is the recommendation for managing asymptomatic patients with carotid atheroscle- rotic stenosis?
Previous randomized trials have shown that prophylac- tic carotid endarterectomy (CEA) in appropriately selected patients with carotid stenosis results in a relative risk reduc- tion of stroke of 53% and an absolute 5-year risk reduction of 6% compared with patients treated by medical management. However, since these trials were performed, medi- cal management has improved. The question has been raised if invasive treatment of carotid bifurcation disease remains an effective way to reduce stroke risk compared to contemporary medical management alone.