Screening for asymptomatic internal carotid artery (ICA) stenosis has been a controversial topic for many years. In 1995, the Asymptomatic Carotid Atherosclerosis Study (ACAS) was published, showing a reduction in ipsilateral stroke among patients with stenosis of 60% to 99% who underwent carotid endarterectomy (CEA).1 This led to a sharp rise in the volume of CEA procedures and calls to screen middle-aged and elderly individuals with no symptoms of a recent transient ischemic attack or ischemic stroke.
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Chaturvedi S. To Screen or Not to Screen for Carotid Stenosis: Is That the Question? JAMA Neurol. 2021;78(4):383–384. doi:10.1001/jamaneurol.2020.5382
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