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Carotid Artery Stents

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Evolution of Carotid Artery Stents

During the first attempts at CAS, the embolic stroke rate was higher than standard CEA. Attempts at reducing this risk were first trialed with distal protecting devices. Initially, a balloon was inflated downstream to the carotid lesion which would prevent emboli from traveling onward to the brain. However once the balloon was deflated there still posed a stroke risk.

In an effort to continue to improve results, a filter was used in place of a balloon. While the filters provided somewhat better protection, they can miss microembolization and also create microemboli upon deployment and removal. This realization soon gave way to the flow reversal system, which has proven to have a very high stroke protection. Overall, CAS has proven to be non inferior to CEA and is incredibly useful in poor surgical CEA candidates.

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