Until further studies are performed, the recommendations for prevention of stroke in women with carotid disease (symptomatic or asymptom- atic) remain the same as for men, as published in the primary and secondary prevention guidelines.19,20 For aspirin, the recommendations below for women are as published in the AHA s Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women. 21 Strategies for Prevention of Stroke in Women: Recommendations 1. Women with asymptomatic carotid stenosis should be screened for other treatable risk factors for stroke, and appropriate lifestyle changes and medi- cal therapies should be instituted (Class I; Level of 2. In women who are to undergo CEA, aspirin is recom- mended unless contraindicated, because aspirin was used in every major trial that demonstrated efficacy of CEA (Class I; Level of Evidence C). 3. Prophylactic CEA performed with <3% morbidity/ mortality can be useful in highly selected patients with an asymptomatic carotid stenosis (minimum 60% by angiography, 70% by validated Doppler ultrasound) (Class IIa; Level of Evidence A). 4. For women with recent TIA or IS within the past 6 months and ipsilateral severe (70% 99%) carotid artery stenosis, CEA is recommended if the periop- erative morbidity and mortality risk is estimated to be <6% (Class I; Level of Evidence A).20 5. For women with recent TIA or IS and ipsilateral moderate (50% 69%) carotid stenosis, CEA is rec- ommended depending on patient-specific factors, such as age and comorbidities, if the perioperative morbidity and mortality risk is estimated to be <6% (Class I; Level of Evidence B).20 6. When CEA is indicated for women with TIA or stroke, surgery within 2 weeks is reasonable rather than delaying surgery, if there are no contraindica- tions to early revascularization (Class IIa; Level of 7. 