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Carotid endarterectomy. Which diagnostic imaging technique is suitable for the indication and planning of surgery?

Based on data of recent literature, the most suitable preoperative diagnostic approach to cerebrovascular insufficiency, is evaluated. Correct indications for carotid endarterectomy in symptomatic and asymptomatic carotid stenoses are related to the degree of stenosis. This is also the most important predictive factor of stroke ipsilateral to the stenosis. Arteriography is being used selectively, while color Doppler US is the examination of first choice, combined with MR-angiography, cerebral CT and transcranial Doppler in most cases of carotid stenosis to be treated with surgery. An accurate and reliable preoperative diagnostic evaluation, together with an impeccable surgical procedure represents the indispensable prerequisite to maintain the mortality and complications within those strict limits that make a prophylactic intervention as carotid endarterectomy, advantagious to the patient.