2 Indications and current treatments
2.1 Narrowing of the carotid arteries by atherosclerosis may lead to transient ischaemic attack (TIA) or stroke. Treatment includes managing cardiovascular risk factors (stopping smoking, taking antithrombotic medication and statins). In some people, surgical revascularisation (carotid endarterectomy) or carotid artery angioplasty and stenting may be considered. Debris dislodged during carotid artery stenting can embolise to the cerebral circulation and cause a TIA or stroke.
2.2 The risk of an embolic stroke during carotid artery stenting may be reduced either by using filters to capture any embolic debris (distal neuroprotection) or by temporarily reversing the blood flow through the stenotic lesion and away from the brain by blocking the flow in the carotid artery (proximal neuroprotection).
2.3 Neuroprotection devices may be introduced via the femoral or carotid artery.