What additional management/workup would you recommend, if any, for patients found to have asymptomatic carotid artery stenosis > 70% (i.e., during the workup of TIA) in the primary care setting? Do you refer for surgical revascularization, or pursue intensive medical management without surgical referral?

What additional management/workup would you recommend for a patient with asymptomatic carotid artery stenosis > 70% (i.e., found during the workup of TIA) in the primary care setting?

• Repeat carotid artery imaging in 6-12 mo
• Optimize vascular disease risk factors (i.e., high dose statin, smoking cessation)
• Refer to vascular surgery
• Other