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Endovascular Angioplasty with Stenting (CAS)

What is endovascular angioplasty with stenting?

Endovascular angioplasty with stenting is an option for patients with carotid stenosis who are high risk for carotid endarterectomy or who cannot undergo surgery.

How is carotid artery angioplasty with stenting (CAS) performed?

Carotid artery angioplasty with stenting (CAS) is a minimally invasive procedure in which a very small hollow tube, or catheter, is advanced from a blood vessel in the groin to the carotid arteries. Once the catheter is in place, a balloon may be inflated to open the artery and a stent is placed. A stent is a cylinder-like tube made of thin metal-mesh framework used to hold the artery open.

Because there is a risk of stroke from bits of plaque breaking off during the procedure, an apparatus, called an embolic protection device, may be used. An embolic protection device is a filter (like a small basket) that is attached on a guidewire to catch any debris that may break off during the procedure.

Johns Hopkins has among the best results in the country for surgery for carotid stenosis, with a published rate of 0.8% mortality and 1.8% morbidity.

For more information, contact the Johns Hopkins Cerebrovascular Center at 410-955-2228.


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