Andreas Kastrup, MD, Department of Neurology, Friedrich-Schiller-University of Jena, Jena, Germany.
Klaus Gröschel, MD, Department of Neurology, Friedrich-Schiller-University of Jena, Jena, Germany.

Atherosclerotic carotid artery stenosis is relatively frequent in older patients and is a major cause of disabling stroke or death. Carotid endarterectomy is currently considered the standard of care for all patients with severe symptomatic and asymptomatic carotid stenosis. However, data regarding the efficacy of this treatment in the older patient are limited. In the past few years, carotid angioplasty and stenting have increasingly been used as an alternative to surgery. Although these endovascular techniques have the advantage of avoiding general anesthesia and surgical incisions, preliminary trial data do not support their widespread use in older patients.

Key words: carotid stenosis, carotid endarterectomy, angioplasty, stent, old age.