Carotid arterial stenting

Carotid arterial stenting (CAS) is a minimally invasive endovascular interventional procedure that can potentially offer the same advantage as surgery (carotid endarterectomy).

Indications for carotid stenting are evolving with endarterectomy trials that evaluate the carotid stenosis cutoff values for treatment. Currently, the indications include:

  • symptomatic patients with ≥70% stenosis (NASCET trial)
  • asymptomatic patients with >60% stenosis (ACAS study) 
  • symptomatic patients with stenosis of at least 50-69% stenosis
  • complete carotid occlusion
  • major disabling stroke on the ipsilateral side/disabling dementia
  • intracranial tumor/hemorrhage
  • thick calcification at the site of carotid stenosis
  • The first percutaneous transluminal carotid angioplasty (PTA) was performed by Charles Kerber in 1980 5
  • Somewhat surprisingly the word 'stent' is actually an eponym, originally named after Charles Stent (1807-1885), a largely-forgotten British dentist. He invented an improved material for forming dental impressions, and set up a company to manufacture it. During the Great War, J F Esser, a Dutch surgeon used a mold of Stent's Compound as a fixative for skin grafting in injured infantrymen. This innovative use, was rapidly adopted into practice, and stenting as a concept rapidly segued into multiple specialties 7.
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Article information

rID: 13315
Synonyms or Alternate Spellings:
  • Carotid stenting
  • Carotid arterial stenting (CAS)
  • Carotid artery stenting

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Cases and figures

  • Left ICA
    Case 1: pre stent angiogram
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  • Post carotid sten...
    Case 1: post stent angiogram
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  • Case 2: ICA stenosis
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  • Final stent
    Case 2: post stenting
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  • Case 3
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  • Case 4: instent stenosis
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