New developments in endovascular interventions for extracranial carotid stenosis

We provide an overview of recent developments in carotid interventional tec hnique and equipment including new stents and emboli protection devices. Th e newer self-expanding stents lessen the problem of external stent compress ion associated with balloon expandable stents, but precise deployment and t he matching (by length) of stents to lesions remain problematic. We also di scuss emerging pharmacologic strategies for cerebral protection in stroke. Multiple randomized clinical trials and multicenter registries are under wa y to compare percutaneous with surgical strategies for the treatment of car otid stenosis. These include the evaluation, of emboli protection devices, and, to a lesser degree, intravenous glycoprotein IIb/IIIa antagonists. Oth er clinical trials are aimed towards refining the ability to stratify patie nts by risk, in order to identify the subsets that would benefit most from these complex and expensive procedures.