Atherosclerosis of the brachiocephalic arteries is a systemic pathological process that plays a leading role in the development of ischemic stroke and chronic cerebrovascular disease. This expert consensus, developed with a multidisciplinary approach, summarizes current data on the pathophysiology of cerebral atherosclerosis, describes contemporary diagnostic and risk stratification tools, and analyzes the latest 2024–2025 recommendations on stroke prevention, highlighting interdisciplinary differences in invasive and conservative management strategies for asymptomatic and symptomatic carotid stenosis. It is emphasized that optimal stroke prevention requires personalized pharmacotherapy, active correction of risk factors, consideration of cerebro-metabolic health, and clinical decision-making within a multidisciplinary team. Promising directions in this field include the implementation of methods based on the integration of artificial intelligence, proteomics, and other omics technologies for more accurate risk assessment and personalized prevention.
Tanashyan et al. (Mon,) studied this question.