Carotid artery stenting: current status and future directions

Carotid endarterectomy has been the mainstay of therapy for carotid occlusive disease in stroke prevention. Recent advances in endovascular technology has made carotid angioplasty and stenting a therapeutic modality in the treatment of carotid occlusive disease. The enthusiasm for this minimally invasive carotid intervention is hampered by the possibility of stent-related cerebral embolization, which can result in neurologic complications. Although current available data indicate that the results regarding success and complication rates are similar between carotid stenting and endarterectomy, numerous prospective clinical trials are currently underway to evaluate the efficacy of carotid artery stenting using various forms of cerebral protection devices. This article reviews the current status of carotid stenting, including recent clinical studies and ongoing prospective trials. Strategies relating to cerebral embolization protection are also discussed.