Carotid Artery Stenting

Carotid artery stent is one of the treatment options for symptomatic (recent major stroke or mini stroke - TIA) or asymptomatic carotid artery stenosis. It is a minimally invasive procedure performed under local anaesthesia in the interventional radiology suite under fluoroscopic guidance.

Stenting trials showed that carotid angioplasty and stenting (CAS) is suggested rather than surgical endarterectomy in high grade stenosis (70 – 99%) in the following conditions:

-          A carotid lesion that is not suitable for surgical access

-          Radiation-induced stenosis

-          Restenosis after endarterectomy

-          Contralateral vocal cord paralysis

-          Open tracheostomy (1).

Stenting trials, such as CREST (Carotid Revascularisation Endarterectomy vs Stenting Trial) or ICSS (International Carotid Stenting Study) showed that carotid stenting tended to have greater benefit at younger ages (less than 70), while endarterectomy tended to have greater benefit at older ages (2).