Latest developments in carotid artery stenosis have gained significant importance with medical advancements in the 2024–2025 period. Carotid artery disease is a condition that significantly increases the risk of stroke due to narrowing or blockage in the arteries supplying blood to the brain. In this article, you can review innovations in many areas, from diagnosis to treatment, presented as headings.
1. Prominent Developments in Surgical Treatment
Carotid Endarterectomy (CEA) and Carotid Stenting (CAS)
Carotid endarterectomy (CEA) and stenting (CAS) are both effective methods for treating carotid artery disease. While recent data indicate that endarterectomy yields better results than stenting, the success rate of the stenting method is also quite high in experienced hands.
In studies, the 30-day stroke or death rate for both asymptomatic and symptomatic patients is below 2% for both treatments.
Transcarotid Revascularization (TCAR)
TCAR is a hybrid method performed directly on the carotid artery, reducing the likelihood of clots reaching the brain.
A large comparative study published in JAMA Network Open in 2025 showed that TCAR reduced the risk of stroke by 40–70%.
🔗 Source: PubMed / interhospi.com
2. Innovations in Drug Therapies
PCSK9 Inhibitors: Evolocumab
Evolocumab is a new drug that provides significant improvement in carotid plaques.
The SLICE-CEA CardioLink-8 study, presented at the 2024 ESC Congress, demonstrated a reduction in lipid core volume.
🔗 Source: ESC Congress abstracts
Colchicine and Inflammation Prevention
Although anti-inflammatory drugs like colchicine have the potential to reduce inflammation in carotid plaques, the CONVINCE study did not achieve statistically significant results.
3. Innovations in Imaging and Diagnostic Technologies
Detailed Vascular Imaging
High-resolution MRI and CT angiography allow for the examination of plaque internal structure, presence of hemorrhage, and fibrous cap. This provides a great advantage in deciding on treatment.
AI-Supported Ultrasound
A Chinese study in 2024 enabled general practitioners to reach expert-level proficiency with AI-supported portable ultrasound devices. Scans performed with these devices increased accuracy rates and halved the time to diagnosis.
🔗 Source: Ultrasound in Medicine & Biology
4. Artificial Intelligence and Digital Health
AI algorithms can detect the presence of plaque with 89% accuracy by evaluating ultrasound images.
Telemedicine applications improve the quality of home care through blood pressure monitoring, medication reminders, and risk factor management.
5. Lifestyle and Preventive Approaches
The following lifestyle measures are emphasized in carotid disease:
- Blood pressure: < 140/90 mmHg
- LDL cholesterol: < 70 mg/dL
- Smoking cessation
- Mediterranean diet
- 150 minutes of moderate exercise per week
In patients who achieve these goals, plaque progression decreases, and stroke risk is reduced.
Conclusion
In 2024–2025, for carotid artery disease:
- Surgical innovations like TCAR,
- Evolocumab and other lipid-targeting drugs,
- AI-supported diagnostic systems,
- Detailed vascular imaging techniques
have led to the development of more effective, personalized, and safer treatment strategies.
This comprehensive approach reduces the risk of stroke and makes treatment processes safer.
Key Highlights
- The TCAR method reduces stroke risk by 40–70%.
- PCSK9 inhibitors like Evolocumab are effective in plaque regression.
- AI-supported ultrasound can increase diagnostic accuracy to 89%.
- Lifestyle changes (Mediterranean diet, regular exercise, smoking cessation) reduce stroke risk.
