Stroke, or cerebral infarction, is the acute development of afocal neurologic deficit caused by the disruption of blood supply to an area of the brain. Strokes can be ischemic, due to occlusion of a bloodvessel, or hemorrhagic, due to rupture of a blood vessel. The presence of significant atherosclerotic disease at the carotid artery bifurcation is believed to represent a major treatable risk factor for future stroke.

Degree of Stenosis  was correlated with an increase in stroke risk, and lesions from 70% to 99% were much more likely to progress to stroke on medical therapy than were lesions of 50% to 69% diameter stenosis, whereas lesions of less than 50% stenosis were unlikely to result in subsequent neurologic symptoms.

Presence of Contralateral Disease, Plaque Progression, Plaque Character, percentage of stenosis, smoking history, renal  insufficiency, plaque area, and plaque character are associated with increased risk of stroke for patients with asymptomatic carotid stenosis.

Open Surgical  Carotid Endarterectomy Plus Best Medical Therapy for Patients with Severe Bifurcation Stenosis is the Best option showing a  clear benefit of CEA for stroke risk reduction in symptomatic patients with stenosis of 70% to 99%.

Carotid Artery Stenting is an alternative in  patients at low risk of Carotid Artery Stenting  associated Complications and in hostile neck as well as in patients with  severe uncorrectable  cardiac conditions.