Piotr Musialek1, MD, DPhil; Eugenio Stabile2, MD, PhD
1. Jagiellonian University Department of Cardiac & Vascular Diseases, John Paul II Hospital, Krakow, Poland; 2. Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, Naples, Italy
With the long-term equipoise of carotid artery stenting (CAS) and carotid endarterectomy (CEA) demonstrated unequivocally in CREST and other large studies, the debate between CAS and CEA today is about the (mostly minor) strokes within the first 30 days after the procedure. With conventional (single-layer) carotid stents, the risk for cerebral embolisation (unlike in CEA) continues post-procedurally1, i.e., when the embolic protection device is no longer able to capture the debris. As 40-80% of strokes associated with conventional-stent CAS are post-procedural, minimisation of periprocedural embolism and elimination of post-procedural embolism are critical for the future of CAS2.##...