Carotid artery disease is a major cause of stroke, which remains the second leading cause of death globally [1]. The importance of a multidisciplinary post-stroke recovery team has been well documented in the literature, yet descriptions of team-based approaches for carotid artery disease management are lacking [2]. Modern management of carotid artery disease requires medical, interventional, and surgical expertise. Specialties, including vascular surgery, neurology, neurosurgery, endovascular surgical neuroradiology (from background specialties of neurology, neurosurgery, and neuroradiology), primary care, cardiology, and vascular medicine, each play a role in delivering diagnostic, preventative, and therapeutic care to patients with carotid disease [3,4]. Although atherosclerotic disease is the most encountered pathology, carotid aneurysms, carotid body tumors, fibromuscular dysplasia, radiation arteritis, connective tissue disorders, and other more rare disease states can frequently be encountered at large, tertiary medical centers [5]. With each of these forms of carotid artery disease having its own diagnostic criteria, natural history, and treatment algorithm, multidisciplinary involvement is essential to delivering appropriate care.

In having multiple points of patient contact and entry into our health care system, we have tried to allow independent management of these disorders by physicians with expertise, while fostering a team-based discussion forum for complex patients who may benefit from multiple different viewpoints. A multidisciplinary team approach to complex disease has been found to improve patient and health care system outcomes across several domains of medicine, namely cardiovascular care [6]. In this review, we will address how the Cleveland Clinic uses a team-based approach to addressing the care of complex carotid artery disease. From diagnosis to developing treatment plans for complex patients, we hope to highlight the benefits of collaboration for both patients and practitioners.