Evaluating the Efficacy and Safety of Carotid Artery Stenting: A Retrospective Analysis

Objective Stroke is the second leading cause of death and the third leading cause of disability globally, with carotid artery stenosis contributing to approximately 20% of cases. Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are effective treatments to reduce stroke risk. While some studies report higher complication rates for CAS compared to CEA, others demonstrate comparable outcomes, emphasizing the importance of patient selection and procedural optimization. This study evaluates the real-world safety and effectiveness of CAS in 52 patients at a single institution. Methods This retrospective analysis included 52 patients who underwent CAS between 2020 and 2024. Inclusion criteria were >= 50% stenosis for symptomatic patients and >60% stenosis for asymptomatic ones. Dual antiplatelet therapy was initiated preoperatively, and distal filter embolic protection was used in all procedures. Neurological assessments and radiological imaging were performed pre- and post-procedure. Complications were categorized as periprocedural or post-procedural, and follow-ups were conducted at three, six, and twelve months. Results The cohort included 52 patients (78.8% symptomatic, mean stenosis rate: 80.3%+/- 12.5%). Periprocedural ischemic stroke occurred in 5.8% of patients, and asymptomatic diffusion-restricted areas were detected in 34.6% of patients. One patient (2.2%) experienced symptomatic intracerebral hemorrhage. The overall periprocedural stroke and death rate was 7.7%. Conclusion CAS is a minimally invasive, effective option for treating carotid artery stenosis when patient selection and procedural protocols are optimized. Ongoing advancements in techniques and devices are anticipated to reduce complications further, supporting CAS as a safe alternative to CEA in selected patients.