ABSTRACT
This chapter describes one vascular surgeon’s approach to carotid angioplasty and stent placement (CAS). Carotid angioplasty and stent placement is an evolving technique in the treatment of patients with carotid occlusive disease. As the procedure becomes more standardized and as novel stents and embolic protection devices become more widely available, it may supplant carotid endarterectomy (CEA) in the treatment of many patients with both symptomatic and asymptomatic high-grade stenosis of the carotid bifurcation. Therefore it is imperative that vascular surgeons become facile with carotid angiography and intervention. All patients considered for CAS should have informed consent and counseling regarding the risks/benefits vis-a-vis CEA and “best medical therapy,” and a clear understanding as to the investigational nature of the procedure. Carotid angioplasty, once felt to be an experimental in nature, is considered a complementary procedure in the treatment of patients with carotid artery stenosis.
