[Carotid artery stenting--controversy of indication and clinical results]

Carotid endarterectomy (CEA) is a well-established surgical treatment for carotid artery stenosis. Carotid artery stenting (CAS) is a preferred treatment strategy in high-risk patients requiring surgery. Lacunar stroke has been the most prevalent stroke type among the Japanese. Recently carotid artery atherosclerotic thrombosis cases have been more frequently in Japan. Poor of CAS results are obtained with thrombo-embolic complications. Distal protection devices have been developed to avoid such complications. Even though approved indication for CAS is high risk associated with surgery, it is being increasingly employed since SAPPHIRE trial of 2004. Some trial proved negative results against CAS. Patient selection for CAS is still controversial. Indications and results of CAS are discussed.