Carotid stenting: a technology in evolution

Interest in stenting lesions involving the carotid artery bifurcation has grown during the past 10 years. Techniques first utilized by Theron and Mathias in Europe and Roubin and colleagues in the United States have evolved to where the technique has been extensively refined and its safety and efficacy firmly established. The only prospective randomized study comparing carotid stenting with carotid endarterectomy, CAVATAS (Carotid and Vertebral Artery Transluminal Angioplasty Stenting), showed similar safety profiles and long-term results for both techniques. A large scale NIH-sponsored trial is now in progress, CREST (Carotid Revascularization Endarterectomy versus Stent Trial), but the results are 5-6 years away. In the interim, one approach toward instituting a carotid stent program is described.