The article discusses the advantages of endovascular treatment of carotid artery atherosclerosis as an effective alternative to traditional carotid endarterectomy. Based on the results of the international ACST-2 study, comparable efficacy of carotid stenting and endarterectomy in preventing ischemic stroke and reducing mortality is demonstrated. Data on the clinical advantages of the endovascular approach, including a reduced risk of myocardial infarction, cranial nerve damage and a shorter rehabilitation period are presented. Particular attention is paid to the effectiveness of endovascular methods in complex anatomical variants of damage, in patients at high surgical risk and in multifocal atherosclerosis. Statistical data on the superiority of endovascular thrombectomy over drug therapy in acute ischemic stroke are provided, demonstrating a significant increase in the functional independence of patients and a decrease in mortality. Technological aspects of modern endovascular techniques providing effective revascularization with minimal trauma to the vascular wall are discussed. The materials of the article are of interest to vascular surgeons, endovascular specialists, neurolo
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