Furthermore, medications offer a better alternative than either surgery or stenting for many patients, according to the guidelines. In the latest clinical trials comparing the procedures, all patients received optimal medical treatment and there were no medication-only groups.

"The risks of these procedures have fallen considerably, but you need to make sure you have very experienced practitioners performing the latest techniques," Halperin said.

The full text of the guidelines will be published in Circulation: Journal of the American Heart Association; Stroke: Journal of the American Heart Association, and Journal of the American College of Cardiology. The guideline executive summary will be in Catheterization and Cardiovascular Interventions, Journal of Cardiovascular Computed Tomography, Journal of NeuroInterventional Surgery, Journal of Vascular Surgery, and Vascular Medicine.

The guidelines were developed with the American Association of Neuroscience Nurses; American Association of Neurological Surgeons; American Society of Neuroradiology; American College of Radiology; Congress of Neurological Surgeons; Society for Atherosclerosis Imaging and Prevention; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology; Society for NeuroInterventional Surgery; Society for Vascular Medicine; and Society for Vascular Surgery.

SOURCE American Heart Association