Abstract
Abstract Carotid endarterectomy remains the clinical golden standard in 2018 for the treatment of severe internal carotid stenosis despite the accumulated clinical experience with carotid artery stenting angioplasty (CAS). In appropriately selected patients based primary on anatomic criteria, CAS has proven to be a safe, minimally invasive alternative carotid intervention. In the periprocedural phase (Day 0 thru 30) after CAS, there needs to be improvement due to the continued risk of embolic stroke. In achieve similar procedural stroke rates between CEA and CAS, the key determinants are interventionists experience, lesion selection, and stent design. From a technical standing, the evolution of embolic protection devices, e.g. flow reversal technique, and stent design have reduced CAS stroke risk. Recently, the uses of dual layer micromesh stents have demonstrated their safety and efficacy in clinical trials. Our vascular group is convinced stent graft design evolution will further improve the CAS outcomes and make it a complementary treatment with CEA in selected clinical settings.
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