Table 5. Important recommendations about treatment techniques (CEA, CAS).

CEA	GoR	LoE
The surgical method (eversion endarterectomy or conventional endarterectomy) should be chosen on the basis of the surgeon’s personal experience.	↑	1
In conventional endarterectomy, the use of a patch significantly lowers the rate of perioperative stroke and death as well as the perioperative carotid occlusion rate and the rate of restenosis later on in the postoperative course.	↑ ↑	1
In elderly patients with an indication for carotid revascularization, CEA should be considered, especially if the arterial morphological anatomy is not suitable for endovascular intervention.	↑	1
There is inadequate evidence to support the routine (obligatory) insertion of a shunt during surgical carotid reconstruction.	↑ ↑	2
Intraoperative neuromonitoring during CEA is not evidence-based, but a pathological finding during monitoring can imply an indication for the selective use of a shunt while the carotid artery is clamped.	↔	5
Patients and surgeons can choose a procedure under local or general anesthesia; the use of one or the other yields no significant difference in outcome at 30 days. The decision regarding anesthesia should take account of the patient’s wishes and the individual experience and skills of the anesthesiologist and vascular surgeon.	↑ ↑	1
CAS	GoR	LoE
In the endovascular treatment of carotid stenosis, primary stent implantation is the method of choice.	↑ ↑	2b
In all cases of carotid stenting, self-expanding stents that have been approved for this indication should be used.	↑ ↑	3
For the assessment of in-stent re-stenosis, standardized Doppler criteria must be used so that structural changes can be detected in long-term follow-up.	↑ ↑	2
PTA alone carries a higher rate of restenosis than CAS.	↑	3
Patients should be given dual platelet inhibition with acetylsalicylic acid and clopidogrel in the peri-interventional period and for at least one month after CAS.	↑ ↑	1

CAS, carotid stenting; CEA, carotid endarterectomy; LoE, level of evidence; PTA, percutaneous transluminal angioplasty