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Online ISSN 1827-1847
Willaert W. I. M. 1, Vermassen F. 2, MacDonald S. 3, Desender L. 2, Jacobs B. 1, Van Herzeele I. 2, 4
1 Department of Thoracic and Vascular Surgery AZ Maria Middelares Hospital, Ghent, Belgium;
2 Department of Thoracic and Vascular Surgery Ghent University Hospital, Ghent, Belgium;
3 Department of Radiology, Freeman Hospital Newcastle upon Tyne, UK;
4 Department of Biosurgery and Surgical Technology Imperial College London, London, UK
The minimal invasive nature of carotid artery stenting (CAS) remains appealing to both interventionalists and patients. Despite numerous landmark randomized controlled trials comparing CAS to carotid endarterectomy, controversy with regards to the precise indications for CAS still exist. What has become clear is that outcome is strongly influenced by patient and operator specific characteristics. Complication rates (i.e. stroke) rise if the procedure is performed by inexperienced interventionalists without sufficient institutional experience or in patients with severe co-morbidities and/or adverse anatomy. This article outlines the different variables associated with inferior CAS outcome and provides strategies to improve CAS results by adopting a patient and physician tailored approach to this complex procedure.