The carotid artery and stroke.

Carotid artery atherosclerosis is the single most important cause of stroke. However, when transient ischemic attacks or strokes occur, it is important for the physician to consider other potential stroke mechanisms as well, including cardiac sources of embolus and intracranial arterial disease. Possible candidates for carotid endarterectomy include symptomatic patients with 75 percent or greater stenosis of the carotid artery and patients with ulcerated or less stenotic lesions in whom medical therapy has failed. Almost all patients with asymptomatic carotid stenosis should be managed with antithrombotic therapy and careful attention to risk factors.