• Carotid endarterectomy should be considered in patients who are symptomatic (TIA or ischemic stroke in distribution of affected vessel) with high-grade carotid stenosis (70-99%) without relative contraindications (persistently disabling neurologic deficits, life expectancy < 5 years, etc.)
• Key idea: Carotid endarterectomy does NOT reverse the damage from the stroke that has already occurred, but would decrease risk of further strokes/TIA
• Key idea: All patients with carotid artery stenosis should be initially managed with intensive medical management (aspirin, statin, BP control) and lifestyle interventions (quitting smoking, weight loss, etc.)

https://step-prep.org/tutoring/

Your vascular surgeon may recommend you have a carotid endarterectomy if you have: A moderate (50-79%) blockage of a carotid artery and are experiencing symptoms such as stroke, mini-stroke or TIA (transient ischemic attack). A severe (80% or more) blockage even if you have no symptoms.