The carotid arteries are a pair of arteries in the neck that take much of the blood flow to the brain. Plaque can build up in the carotid arteries over many years, causing the arteries to narrow. This will often be a silent process without symptoms, but may eventually result in an interruption in the blood supply to the brain causing a stroke or mini-stroke (also known as a transient ischaemic attack, or TIA). If a minor stroke or TIA occurs, then this is often prelude to a much larger stroke if ignored. Treatment of carotid artery disease usually includes medications to help reduce the risk of future stroke, and control of risk factors such as high blood pressure. Sometimes surgery is also considered to help reduce the risk of future stroke, particularly if the plaque has previously caused TIAs or minor strokes. This is commonly performed with an operation to physically remove the dangerous plaque in the carotid artery, called an “endarterectomy”. Sometimes stenting is recommended as an alternative, particularly if there are factors that increase the risks of surgery.