Matching carotid anatomy with carotid stents

Carotid artery stenting (CAS) has emerged as a promising minimal invasive treatment alternative to carotid arterectomy for patients with symptomatic and asymptomatic carotid artery stenosis. Complication rates of CAS continuously decreased during recent years. Operator experience and technical improvements equally contributed to the improved safety of the procedure. Today, devices specifically designed to fit the requirements of carotid interventions are available and allow a lesion-tailored interventional strategy. The choice of stents seems to play an important role in achieving optimal outcomes with the endovascular technique. Basically, three major types of stents are currently available: open cell nitinol stents, closed cell nitinol stents, and closed cell Elgiloy stents. The concept of cell design has implications on plaque coverage, but also on mechanical properties of the devices and conformation to carotid anatomy. The present review discusses the concept of lesion-tailored stenting to optimize early and late outcomes after CAS.