[Asymptomatic carotid stenosis: What is new?]

In industrialized countries, stroke is still the most common disease that leads to permanent disability. Of the 250 000 strokes that occur annually in Germany, in about 80 % are cerebral ischemia. Approximately 15 % of these ischemias are caused by lesions of the extracranial internal carotid artery, so optimal treatment of extracranial carotid stenosis is essential 1. This continues to be the subject of a controversial debate, as optimized drug therapy has led to a significant reduction in risk.In 2020, the multidisciplinary S3 guideline for the management of extracranial carotid stenoses was updated. In the following, current aspects and new recommendations for asymptomatic carotid stenosis are presented and important innovations of the guideline are explained.