Experts warn this does not necessarily mean there is a causal effect. It is expensive however and diarrhea is common. In one study clopidogrel was slightly more effective than aspirin in reducing risk for stroke, but more research is needed. Anticoagulants significantly increase the risk for bleeding and cerebral hemorrhage, however, and require regular monitoring. This study was conducted on patients with low surgical risks, however, and it did not reduce the rate of major disabling strokes.
Experts still recommend against surgery for patients who have narrowed arteries but no symptoms.
Exceptions may be younger patients, those with access to excellent surgeons, and patients who cannot take anticoagulants. The object of endarterectomy, which takes about an hour, is to clean out and open up the narrowed carotid artery. A by-pass tube is placed to transport blood around the blocked area during the procedure. After the surgeon has scraped away the plaque on the arterial wall, the artery is sewn back together and blood flow is restored directly through the artery. The patient is usually given general anesthesia, although it has been reported that using local anesthetic is just as safe and reduces the cost of the procedure.