Carotid artery surgery and carotid stenting in prevention of strokes.

PURPOSE OF REVIEW: To summarize the randomized trial data comparing carotid endarterectomy with carotid artery stenting and describe ischemic visual symptoms and their presentation to ophthalmologists.

RECENT FINDINGS: Carotid stenosis, symptomatic and asymptomatic, is prevalent and is a significant cause of stroke. Timely evaluation and intervention are important in stroke prevention.

SUMMARY: Carotid endarterectomy remains the standard of care for extracranial carotid stenosis except in specific clinical scenarios. Ongoing and future trials will clarify the role of revascularization methods. The role of carotid artery stenting in acute stroke, including its use in the intracranial circulation, is being investigated. Ophthalmologists should be familiar with ischemic risk factor assessment, appropriate and timely referral for imaging and evaluation and initiation of antiplatelet therapy.