What percentage of stenosis indicates the need for carotid endarterectomy in symptomatic cases?

In symptomatic patients, carotid endarterectomy is recommended when there is at least 70% stenosis of the internal carotid artery. This guideline is based on clinical trials that have demonstrated a significant reduction in the risk of subsequent stroke in symptomatic individuals with severe carotid artery stenosis. The threshold of 70% provides a balance between the benefits of surgery in preventing strokes and the risks associated with the procedure.

Stenosis less than 70% typically does not show a favorable risk-to-benefit ratio for surgical intervention in symptomatic cases, making the option of 70% the threshold for considering carotid endarterectomy in these patients. This guideline underscores the importance of appropriate surgical intervention to improve outcomes in those who are at significant risk of cerebrovascular events.