ABSTRACT
The concept of treating diseases of the carotid bifurcation using endovascular means is not new,
but has lagged behind endovascular treatments in other body segments as a result of the fear of
cerebral embolization. Considering the nature of atheroma at the carotid bifurcation, and the
exquisite sensitivity of the brain to embolic insult, this is perhaps not surprising. However,
to the surprise of many clinicians, carotid angioplasty and stenting have been shown to have
an acceptable safety profile in many situations (see chap. 17) (1-8). In addition an improved
understanding of patient selection and technological advances has made the performance of
the procedure more controlled and probably safer for the patient (8-14). This chapter is
designed to describe the procedural details and techniques that can be employed to minimize
the chances of complications. Chapter 18 addresses the issue of managing these complications,
should they occur, and they will do so despite attention to detail. However, the frequency of
such problems can be kept to a minimum by technical skill and experience.
