[Carotid angioplasty and stenting: a justified therapeutic alternative?]

The efficacy and safety of carotid endarterectomy in the prevention of stroke, demonstrated in 1991, has elevated it to the treatment of choice for the extracranial carotid occlusive disease. The recent advances in endovascular treatment created an enthusiasm for carotid angioplasty and stenting (CAS) which is increasingly becoming an alternative to endarterectomy in high risk patients and more recently for the NASCET-eligible and asymptomatic patients with significant atherosclerosis. Although, the results of CAS must be at least equivalent, in terms of safety, efficacy, stroke prevention on the long term, to the published trials (NASCET, ECST, ACAS) in order to justify any change in the gold standard in the treatment of carotid bifurcation disease, which remain carotid endarterectomy.