Assessment and Management of Carotid Disease

27103 ABSTRACT Recent reports of results of clinical trials comparing carotid endar­ terectomy with medical treatment for carotid stenosis have clarified the relationship of extracranial carotid stenosis to symptomatic cerebro­ vascular disease. Results ofthese trials emphasize the importance of sever­ ity of carotid stenosis in therapeutic decision making. In addition, however, presence of carotid stenosis identifies individuals with an excess burden of cardiovascular disease risk factors and atherosclerosis of other (e. g. coronary) arteries. In parallel with growing awareness of the clinical rel­ evance of extracranial carotid stenosis, new population-based studies and studies in symptomatic populations are defining the risk factors for extra­ cranial carotid atherosclerosis and atherosclerosis progression. These new investigative approaches promise to increase substantially our under­ standing of the pathogenesis and clinical consequences of cerebrovascular disease in the forthcoming years.