Indications and contraindications in carotid endarterectomy and stenting

1. Big picture

Carotid endarterectomy and carotid artery stenting are revascularization procedures used to prevent recurrent ischemic stroke in selected patients with extracranial internal carotid artery stenosis. The key exam idea:

Not every carotid stenosis should be operated. The strongest indication is symptomatic severe internal carotid artery stenosis after TIA or minor ischemic stroke.

The lecture’s central rule is:

Carotid endarterectomy or stenting within 2 weeks if symptomatic carotid stenosis is 70–99%, but only after TIA or minor stroke — not after large completed stroke, not in total occlusion.

Modern guideline logic is similar: carotid endarterectomy, CEA, is recommended