A refined angioplasty and stenting technique may offer an alternative to carotid endarterectomy.

Strokes are the third leading cause of death in the United States. Carotid artery occlusive disease accounts for about 20% to 30% of all strokes. Carotid endarterectomy has been the traditional standard treatment for patients with significant carotid artery disease. However, surgical therapy is associated with significant complications. Carotid angioplasty and stenting offers an attractive alternative to surgery. There have been significant advances in this field including the use of embolic protection devices. In this article, we review the current literature addressing the role of endovascular interventions in the management of patients with significant carotid stenosis.