Harvard Heart Letter

Carotid stenosis treatments compared

Both surgical and nonsurgical options can prevent stroke.

The same process that causes obstructions in the heart's arteries can block the carotid arteries in the neck, a disease known as carotid stenosis. If these interfere with blood flow, a stroke can occur.

Symptoms of pending stroke (see box) usually require treatment to reduce the risk. One option calls for opening the artery and removing the plaque—a surgical procedure known as endarterectomy. A less-invasive option, called carotid stenting, involves inserting a catheter into an artery in the groin, advancing it to the carotid artery, opening the blockage with a balloon, and leaving behind a wire cage (or stent) to hold the artery open.

Thanks to the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST), we now know both procedures are safe and effective.

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