Basic treatment of patients with carotid stenosis is a permanent complex treatment (lowering of risk factors of atherosclerosis, antiplatelets treatment and the potential use of the inhibitor of angiotensive converting enzyme). Symptomatic stenosis (over 85% in European classification of arteriography) are indicated for the surgery. In smaller stenoses (75-85%), only selected patients are indicated for such treatment. Surgery in asymptomatic stenoses over 75% should be done in strictly indicated cases only. Operation should be performed at clinics with sufficient experience only. In cases without preoperative angiography, indication for surgery should be based on duplex sonography and some other non-invasive method. Endovascular treatment by primary stent is indicated for the most serious cases at the best clinics.

3 interní klinika 1 LF UK a VFN a Subkatedra angiologie IPVZ Praha