Review Article Treatment of Atherosclerotic Disease at the Cervical Carotid Bifurcation: Current Status and Review of the Literature*

Carotid endarterectomy is increasingly used to de-crease the risk of stroke associated with cervical atherosclerotic stenosis, and some investigators claim that the results and benefits for carotid stent-ing are comparable with those of endarterectomy. A review of the literature reveals that there is in-complete knowledge concerning carotid artery ath-erosclerotic disease, its associated risks, the optimal medical therapy, indications for intervention, and the optimal interventional procedures. No trial has evaluated the currently available ‘‘best medical therapy’ ’ or compared it with endarterectomy. Cur-rent data indicate that carotid endarterectomy as it is presently practiced in the United States bears lit-tle relationship to the populations studied, methods used, or results obtained in the North America