Transcranial Doppler Ultrasound in the Current Era of Carotid Artery Stenting.

Since its introduction in 1982, transcranial Doppler ultrasound (TCD) has become an important diagnostic and monitoring tool and its usefulness has been well established in many clinical applications. In carotid artery stenting (CAS), TCD has mostly been reserved for the optimization of emboli protection devices. Currently, with increasing use of proximal protection systems resembling surgical clamps, TCD has become invaluable in providing the operator an insight into a patient's cerebral hemodynamic status. Additionally, in selected patients, adverse peri- or post-procedural cerebral outcomes may even be predicted allowing the operator to adjust the therapeutic strategy. This review summarizes the current knowledge regarding the use of TCD in patients undergoing CAS and suggests potential directions of future research.