Patients with asymptomatic carotid stenosis should be prescribed daily aspirin and a statin. Patients should also be screened for other treatable risk fac- tors for stroke, and appropriate medical therapies and lifestyle changes should be instituted (Class I; Level of Evidence C). 2. In patients who are to undergo CEA, aspirin is rec- ommended perioperatively and postoperatively unless contraindicated (Class I; Level of Evidence C). 3. It is reasonable to consider performing CEA in asymptomatic patients who have >70% stenosis of the internal carotid artery if the risk of periopera- tive stroke, MI, and death is low (<3%). However, its effectiveness compared with contemporary best med- ical management alone is not well established (Class IIa; Level of Evidence A). 4. It is reasonable to repeat duplex ultrasonography annually by a qualified technologist in a certified laboratory to assess the progression or regression of disease and response to therapeutic interventions in patients with atherosclerotic stenosis >50% (Class IIa; Level of Evidence C). 5. Prophylactic CAS might be considered in highly selected patients with asymptomatic carotid stenosis (minimum, 60% by angiography, 70% by validated Doppler ultrasound), but its effectiveness compared with medical therapy alone in this situation is not well established (Class IIb; Level of Evidence B). 6. In asymptomatic patients at high risk of complica- tions for carotid revascularization by either CEA or CAS, the effectiveness of revascularization versus medical therapy alone is not well established (Class IIb; Level of Evidence B). 7. Screening low-risk populations for asymptomatic carotid artery stenosis is not recommended (Class III; Level of Evidence C). Sickle Cell Disease SCD, an autosomal-recessive disorder in which the abnormal gene product is an altered hemoglobin -chain, typically man- ifests very early in life. 