Stenting Versus Best Medical Treatment of Asymptomatic High Grade Carotid Artery Stenosis

Using retrograde transfemoral access an overview aortic angiogram is established. A stiff wire is then placed in the external carotid or distal common carotid artery to introduce a long hydrophilic sheath into the common carotid artery. The stenosis is then crossed with a Filter wire. For stent implantation Monorail Carotid Wallstents or the Monorail Nitinol Stent of Boston Scientific are used. Road map or overlay technique with a magnification of 20 to 28 inch is used to localize the stenosis during the procedure. Finally a control angiogram is performed to ensure correct placement of the stent. After successful completion of the procedure, the arterial access site is closed using a standard closure device.