Carotid angioplasty and stenting. Will they match the gold standard?

Technological advances in endoluminal equipment have changed treatment strategies for vascular disease. While the successful results of intervention in the subclavian and innominate arteries are well documented, our experience in the carotid arterial region is still in the early stages, and we are mindful of the potential for neurologic complications. We now find ourselves in the position of comparing the results of endovascular intervention with those of what has become a classic, "gold standard" procedure, carotid endarterectomy. Although we have yet to determine definitively the superiority of one method over another, it has become clear that some carotid lesions are considerably more amenable to endovascular treatment than others. We must evaluate the type and location of lesions, as well as the technical features of carotid angioplasty and stent placement, when we compare the results of endovascular and open procedures.