Carotid stenting dilation and cerebral angiography. Carotid stenting is the preferred therapy for patients who are at an increased risk with carotid surgery. High risk factors include medical comorbidities (severe heart disease, heart failure, severe lung disease, age > 75/80, etc.) and anatomic features (contralateral carotid occlusion, radiation therapy to the neck, prior ipsilateral carotid artery surgery, intra-thoracic or intracranial carotid disease) that make surgery difficult or risky. Anatomic high surgical risk: Co-morbid high surgical risk: Using the criteria of successful trials, candidates are either symptomatic (TIA or stroke) patients with >50% stenosis of the carotid artery, or are asymptomatic with >80%
Carotid artery stenosis for screening for carotid artery stenosis depends on whether someone is experiencing symptoms arising from the stenosis or has risk factors for the development of carotid artery disease. The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening for carotid artery stenosis in those without symptoms. While routine population screening is not advised, the American Heart Association recommends screening for people who don’t have symptoms of carotid stenosis but have been diagnosed with related medical conditions or have risk factors for carotid artery disease. Screening is recommended for people who have: The American Heart Association also recommends screening if