angioplasty and stenting of carotid artery stenosis with embolic protection devices

background: carotid artery stenting (cas) has recently been recommended as an alternative to carotid endarterectomy (cea) by some clinicians. objective: this study was designed to evaluate the success rate and in-hospital and 30-day adverse events in our first experiences in iran for cas with protection devices, to document our results and guide further use of cas. methods: from december 2003 to december 2004 we performed 21 consecutive cas procedures. 16 were men and 5 were women with mean age of 62 years (range 46-78 years). indications for cas included primary lesions in all patients with stenosis >50% in symptomatic and stenosis >80% in asymptomatic patients. results: cas was technically successful in a1l 21 patients. mean severity of stenosis before cas was 85%+14% compared with 15%+10% after cas. no periprocedural death occurred. no in-hospital and 30-days minor or major stroke/ death was seen. conclusion: our data suggest that percutaneous stenting of the carotid artery when a cerebral protection device is used is feasible and effective but not without technical difficulties and potential complications. we recommended cas for high-risk patients for carotid endarterectomy, but this technique has a learning curve for those willing to perform the procedure with a low rate of complications.