CAS means opening a narrowed/stenosed carotid artery by placing a stent.
Indications of CAS are:
• One or more TIAs in 6 months + carotid artery stenosis >50%
• Progressive stroke + carotid artery stenosis >50%
• Carotid stenosis >70%A
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
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.