Imaging for carotid stenting

Carotid artery stenting (CAS) using embolic protection devices (EPD) has emerged as a viable alternative to carotid endarterectomy (CEA) in select patients. Imaging plays a critical role in the selection of patients for CAS. Duplex ultrasonography alone is insufficient to assess patients for CAS suitability. Advancements in computed tomography angiography (CTA) and magnetic resonance angiography (MRA) techniques are helping to identify lesions vulnerable to cerebral embolization during carotid interventions - a more prevalent event during CAS in comparison to CEA. Here we review the relevant data on the various imaging techniques available to improve patient selection and minimize neurologic adverse events during carotid artery stenting.