Recommendations on the prevention and risk optimization in extracranial carotid artery stenosis: an evidence-based and information brochure written in layman′s terms Empfehlungen zur Prävention und Risikooptimierung bei der extrakraniellen Carotisstenose: eine evidenzbasierte und laienverständliche Informationsbroschüre

Schlichting H, Larena-Avellaneda A, Rantner B, Kazarians H, Marquardt L, Adili F, Hinterseher I, Pfeiffer M, Pfeiffer-Krahl M, Rother U, Behrendt CA (2026)

Publication Type: Journal article, Review article

Publication year: 2026

Journal

Gefässchirurgie Springer Verlag

DOI: 10.1007/s00772-026-01313-5

Abstract

Extracranial carotid artery stenosis (narrowing of the carotid artery) is considered a widespread disease affecting more than one billion people worldwide, with approximately 30% of adults aged 45 to 74 in Germany exhibiting pathological thickening of the carotid artery wall. Given that about 15% of the 250,000 strokes in Germany annually are attributable to this condition, early diagnosis via color-coded duplex sonography (ultrasound) and consistent prevention are crucial. Treatment is based on an integrated approach of lifestyle modifications, medical therapy, and invasive procedures. Tobacco smoking is identified as the most significant modifiable risk factor, making strict cessation, alongside a Mediterranean diet and physical activity, the foundation of treatment. Pharmacological therapy necessitates high-potency statins to reduce LDL cholesterol to target levels below 70 mg/dl or 55 mg/dl, as well as the use of antiplatelet agents such as aspirin or clopidogrel. Decisions regarding invasive interventions, such as surgical endarterectomy or stenting, strictly differentiate between symptomatic and asymptomatic patients. Although there is a strong recommendation for surgery in symptomatic stenoses of 50% or more, the indication for asymptomatic patients is increasingly cautious and determined individually within interdisciplinary case conferences. However, current health care data indicate that stroke-free overall survival in routine practice often falls short of clinical trial results, emphasizing the importance of lifelong optimal conservative therapy and regular annual ultrasound follow-ups after any intervention.

Authors with CRIS profile

Ulrich Rother Department of Vascular Surgery

Involved external institutions

Medizinische Hochschule Brandenburg "Theodor Fontane" / Brandenburg Medical School "Theodor Fontane" DE Germany (DE) MSH Medical School Hamburg - Fachhochschule für Gesundheit und Medizin DE Germany (DE) Klinikum rechts der Isar DE Germany (DE) Klinikum Darmstadt DE Germany (DE)

How to cite

APA:

Schlichting, H., Larena-Avellaneda, A., Rantner, B., Kazarians, H., Marquardt, L., Adili, F.,... Behrendt, C.A. (2026). Recommendations on the prevention and risk optimization in extracranial carotid artery stenosis: an evidence-based and information brochure written in layman′s terms Empfehlungen zur Prävention und Risikooptimierung bei der extrakraniellen Carotisstenose: eine evidenzbasierte und laienverständliche Informationsbroschüre. Gefässchirurgie. https://doi.org/10.1007/s00772-026-01313-5

MLA:

Schlichting, Hanna, et al. "Recommendations on the prevention and risk optimization in extracranial carotid artery stenosis: an evidence-based and information brochure written in layman′s terms Empfehlungen zur Prävention und Risikooptimierung bei der extrakraniellen Carotisstenose: eine evidenzbasierte und laienverständliche Informationsbroschüre." Gefässchirurgie (2026).

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