Test.
Indications for carotid artery stenting (CAS) - CORRECT ANSWER Rather than improving flow across
stenotic lesions, CAS addresses the morbidity associated with occlusive disease by stabilizing plaques
prone to embolization in the cerebral circulation.
Patients with certain medical and anatomical factors are high-risk surgical candidates who may be better
suited for CAS than carotid endarterectomy (CEA).
Patients meeting certain high-risk medical and anatomic criteria are indicated for transfemoral carotid
artery stenting (TFCAS) and transcarotid revascularization (TCAR). List medical risk factors: - CORRECT
ANSWER Age 75 years or older (Note: While age ≥75 years is a high risk factor for TCAR, older patients
undergoing TFCAS had a higher risk of stroke likely due to aortic arch disease and lesions crossing with
embolic protection devices.)
Congestive heart failure
Left ventricular ejection fraction 35% or less
Unstable angina
Abnormal stress test
Need for major surgery, including open heart or vascular surgery
Uncontrolled diabetes
Severe pulmonary disease
Anatomic high-risk factors for TFCAS and TCAR include: - CORRECT ANSWER Contralateral carotid
occlusion
Tandem stenoses greater than 70%
High cervical carotid artery stenosis
Restenosis after carotid endarterectomy
Bilateral carotid disease requiring treatment