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Carotid artery stenting

Status: Decision completed

View findings and decision

Policy context

Treatment options for carotid artery stenosis include medical therapy, surgery to remove the atherosclerotic plaques (carotid endarterectomy or CEA), and the percutaneous placement of stents (CAS) in the affected area. In general, persons undergoing CEA or CAS will also be receiving medical therapy. During CAS, the clinician threads a catheter through an artery up from the groin and up to the carotid artery. The catheter has an attached balloon which expands the artery and inserts a stent to hold the artery open. Multiple stents may be placed depending on lesion length. Because there is a risk of disrupting the plaque along the artery walls during this type of procedure, CAS is usually performed along with a filter, or distal embolic protection device (EPD) which is used to capture any debris that becomes dislodged, reducing the risk of embolization.

Primary criteria ranking

  • Safety = High
  • Efficacy = High
  • Cost = Medium

Assessment timeline

  • Draft Key Questions Published: November 26, 2012
  • Public Comment Period: November 26 - December 11, 2012
  • Draft Report Published: June 28, 2013
  • Public Comment Period: June 28 - July 30, 2013
  • Final Report Published: August 15, 2013
  • HTCC Public Meeting: September 20, 2013