Carotid artery stenting 2008.

In an effort to minimize interventions, in the last decade carotid artery stenting (CAS) has been suggested as an alternative to surgical carotid endarterectomy (CEA) for patients with symptomatic and asymptomatic extra cranial obstructive disease. CAS is relatively new compared to CEA and it should be acknowledged that CAS is an evolving technique. As technology has improved, procedural risks have declined and are approaching those reported for CEA. From the individual randomised clinical trial it can be concluded that in patients at high risk for CEA, CAS is an equivalent, maybe better alternative. In symptomatic patients at standard risk for CEA, CAS has not proven non-inferior, and is worse when performed by relatively inexperienced operators without embolic protection device compared to highly experienced CEA surgeons.