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Of the approximately 700,000 new strokes per year occurring in the United States, 5% to 12% result from angiographically demonstrated carotid occlusive disease. Of these atheroembolic strokes, 75% to 80% occur without a warning stroke or transient cerebral ischemic symptoms. Therefore, asymptomatic carotid artery stenosis remains a significant cause of stroke morbidity and mortality. Management of these patients, however, is still one of the most controversial topics in the cerebrovascular disease literature. The Asymptomatic Carotid Atherosclerosis Study (ACAS) and the Asymptomatic Carotid...