ABSTRACT
This chapter reviews the risks and complications of carotid angioplasty and stent placement (CAS). The concept of CAS is that it must have lower morbidity than carotid endarterectomy in a given patient to be an effective treatment. Therefore, avoiding or managing complications becomes crucial to the utility of CAS. Complications associated with the carotid stent site and its cerebral sequelae are almost uniformly unique to CAS. Systemic factors and medical comorbidities that increase the risk of carotid endarterectomy also generally increase the risk of CAS, although to lesser extent than that seen with open surgery. Neurological complications are best avoided by judicious patient selection, both from a standpoint of neurological status and carotid anatomy. Patients at advanced age, with uncontrolled hypertension, frequent or severe neurological symptoms, renal insufficiency, or severe cardiac comorbidities, are at increased risk for CAS.
