karotiidstentingut

Karotid stenting, or carotid artery stenting (CAS), is a minimally invasive endovascular procedure used to treat carotid artery stenosis, a narrowing of the carotid arteries that can raise the risk of stroke. The goal is to widen the artery and restore blood flow to the brain while reducing the chance of future ischemic events.

Indications for CAS include symptomatic carotid stenosis (for example after a transient ischemic attack or stroke within the past six months) and, in selected patients, asymptomatic stenosis with high surgical risk for traditional carotid endarterectomy (CEA). Patient selection considers anatomy, comorbidities, age, and overall surgical risk. CAS is often chosen for patients with prior neck surgery or radiation, significant chest or heart disease, or high risk for anesthesia.

The procedure involves threading a catheter through an arterial access point, usually the femoral or radial artery, to the carotid artery. A stent, either balloon-expandable or self-expanding, is deployed to keep the vessel open. An embolic protection device, such as a distal filter or proximal flow-reversal system, is commonly used to reduce the risk of debris traveling to the brain during the intervention. Patients typically receive antiplatelet therapy before and after the procedure.

Outcomes from CAS have improved with experienced operators and proper patient selection. Trials comparing CAS with carotid endarterectomy show similar long-term stroke rates in many groups but different risk profiles, with CAS carrying a higher periprocedural stroke risk in some populations and CEA associated with higher myocardial or wound complications in others. Follow-up includes duplex ultrasound to monitor restenosis and continued antiplatelet therapy as advised.