What is carotid angioplasty and stenting?

Carotid angioplasty and stenting involves the carotid artery. During the procedure, doctors use a thin tube with a balloon at its tip to open up the artery. The carotid arteries send oxygen-rich blood to your brain. A condition called carotid artery stenosis means that one or both of these arteries are narrowed.

Is carotid artery stenting safe?

Carotid artery stenting is not a good choice for people older than age 70. For people in this age group, the risk of stroke or death during the procedure is too high. Carotid artery surgery (endarterectomy) is usually safer for people older than 70.

How long do carotid stents last?

Once a stent is placed in a carotid artery, the stent permanently stays inside the artery. Once placed, the stent permanently stays inside the artery. There is a 2-3% risk of repeat narrowing if the stent also gets blocked in the future. This usually happens within the first 6-9 months.

Does Medicare cover carotid stents?

Effective July 1, 2001, Medicare covers PTA of the carotid artery concurrent with carotid stent placement when furnished in accordance with the FDA-approved protocols governing Category B IDE clinical trials.

Which is better, CAS or CEA for carotid stenting?

CAS was also preferred over CEA in patients at increased risk of surgery (Class IIb, LOE B). The FDA has cleared or approved more than seven CAS systems for clinical use as “safe and effective” alternatives to CEA. 11 This has been the result of clinical trials involving more than 8,000 patients.

Which is better, carotid artery stenting or endarterectomy?

Atherosclerotic stenosis of the internal carotid artery is an important cause of stroke. Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for the treatment of carotid stenosis.

Which is better stenting or carotid revascularization?

Silver FL, Mackey A, Clark WM, Brooks W, Timaran CH, Chiu D, Goldstein LB, Meschia JF, Ferguson RD, Moore WS, Howard G, Brott TG; CREST Investigators. Safety of stenting and endarterectomy by symptomatic status in the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST).

When to use crest in carotid stenosis patients?

The primary aim of CREST is to assess if the efficacy of CAS differs from that of CEA in preventing stroke, myocardial infarction and death during a 30-day peri-procedural period, or ipsilateral stroke over the follow-up period in patients with symptomatic (>=50%) or asymptomatic (>=60%) extracranial carotid stenosis.

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