ABSTRACT
This chapter provides guidelines for selecting patients best suited to carotid angioplasty and stent placement. Optimal patient selection remains paramount to a beneficial outcome during carotid intervention by endovascular methods, as it may be the best means of preventing complications in the first place. Although endoluminal rescue procedures to ameliorate neurological sequelae from a carotid intervention can be employed, these options are extremely limited and outcomes less reliable when compared to those available to correct endovascular complications in the peripheral vascular tree. The overwhelming majority of carotid interventions are performed through common femoral artery access, with the brachial artery approach being utilized for most others. A variety of anatomical and pathological conditions of the carotid bifurcation influence the technical challenges, risks, and overall efficacy of the procedure. The learning curve in carotid intervention begins after guidewire and catheter skills are mastered in other parts of the arterial-venous tree.
