Abstract
Objective: Carotid artery disease treatment options include optimal medical therapy, surgical carotid endarterectomy (CEA), and endovascular carotid artery stenting (CAS). Clinical trials from the past two decades, comparing CEA with CAS reveal higher periprocedural (up to 30 days) risk of stroke or death with CAS. The higher risk is primarily noted in symptomatic patients (> 70 years old), while in younger and/or asymptomatic patients CEA and CAS outcomes are more comparable.1 Contemporary CAS is carried out by operators of different specialties, including angiologists, (neuro)radiologists, cardiologists, and vascular surgeons, the last of which are slightly underrepresented in the endovascular practice relative to other specialties. Newer generation dual layer micromesh stents (DLMS), were specifically designed to further decrease the CAS related periprocedural cerebral embolisation risk. Their short and long term safety and efficacy is supported by a large body of clinical evidence,2–5 but more studies in broader, unselected, patient populations are needed.
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