ABSTRACT
Most strokes are caused by cerebral infarction in the territory of the carotid arteries, and significant ipsilateral carotid stenosis is found in 20-30% of these cases (1). This observation has led to a search for the most effective form of secondary prevention of stroke in these patients. Large randomized trials have shown that carotid endarterectomy significantly reduces the risk of stroke from severe, recently symptomatic stenosis but this benefit is dependent on a low perioperative complication rate. In recent years, endovascular techniques have been routinely used to treat coronary and peripheral arterial disease. The low complication and high success rates of angioplasty and stenting at these sites mean that they have become the treatment of choice in many patients. There has been some resistance to treating carotid artery disease in the same way because of concern over distal embolization at the time of the procedure. Endovascular equipment and techniques have been developed to combat this problem and are being used increasingly.
