Screening for asymptomatic carotid stenosis: routine or selective?

The current review discusses the advantages and disadvantages of routine vs. selective screening for asymptomatic carotid artery stenosis. The cost-effectiveness of screening programs is discussed. Furthermore, the rationale of offering selective screening, as well as the current recommendations regarding screening for asymptomatic carotid stenosis are presented. A selective screening strategy would identify individuals at high cardiovascular disease (CVD) risk early and would allow the timely initiation of conservative lifestyle measures and best medical therapy to prevent both stroke and CVD morbidity and mortality.