ABSTRACT
Introduction Carotid artery stenting (CS), a less invasive intervention than carotid endarterectomy (CEA), has emerged as a safe and effective method for revascularization of extra-cranial carotid artery stenosis. Recent observational (1-4) and randomized (5,6) trials in well-defined patient subsets have shown that the risk of major procedure-related complications, i.e., stroke and death, is comparable when these interventions are performed in skilled hands. In patients at high risk for CEA, carotid stenting has been established as the revascularization strategy of choice (4). Multicenter, randomized trials [carotid revascularization endarterectomy vs. stent trial (CREST); asymptomatic carotid stenosis stenting versus endarterectomy trial (ACT 1)] are in progress to assess the applicability of carotid stenting in a broader clinical spectrum, i.e., asymptomatic patients with severe carotid artery stenosis and patients at low surgical risk with CEA.
