CAROTID ARTERY STENTING (CAS)

Q1 What is Carotid Artery Stenting (CAS)?

CAS means opening a narrowed/stenosed carotid artery by placing a stent.

Q2 What are indications for CAS?

Indications of CAS are:
Symptomatic patients:
• One or more TIAs in 6 months + carotid artery stenosis >50%
• Progressive stroke + carotid artery stenosis >50%
Asymptomatic patients:
• Carotid stenosis >70%A

Q3 What is carotid endarterectomy (CEA). In which patients CAS is preferable to CEA?

Surgical treatment of carotid artery stenosis is called carotid endarterectomy. Both procedures are good but CAS is preferable to CEA in following patients:
• High risk patients
• Contralateral ICA occlusion
• Post operative and post radiotherapy
• High bifurcation
• Young patients <70 years

Q4 How CAS is done?

Step 1: Femoral artery is punctured and sheath is placed in femoral artery. Then through it guiding catheter is placed into neck vessel.
Step 2: Then stenosis is crossed with the wire and filter is placed distally.

Step 3: Stenosis is dilated with balloon.
Step 4: Stent is deployed across stenosis.

Step 5: Stent is dilated with balloon.

Step 6: Finally filter, guiding catheter and sheath are removed.
CASE: 51yrs male with left ICA stenosis, C/O recurrent TIAs.