Having carotid disease is a risk for stroke, but not an absolute. We know that the risk of stroke increases directly with the amount of blockage (the more the blockage the higher the risk of stroke). The blockage grows very slowly and can usually be followed. In many cases, the most important thing to do is consult with your doctor and usually consult with a vascular surgeon. For many patients, close follow-up with surveillance ultrasounds is all that is necessary. The vascular surgeon can determine the schedule of ultrasounds (usually once or twice yearly), and can determine if and when surgery is necessary to fix the carotid disease.