The potential risk of carotid stenting is stroke, caused by material breaking off the artery wall and traveling to the brain. But stroke is also a possibility in surgery. The investigators hope to show that the stroke rate in stenting is lower than in surgery. To that end, the institute is testing a device to protect the brain during the stent procedure. It's a tiny umbrella that opens in the artery ahead of the stent, between the blockage and the brain.
Blood still flows through, but the device is designed to catch any debris.
At the end of the procedure, it is pulled out through a parachute at the end of a catheter. Coming up with enough evidence to support the use of stents will take at least five years, Katzen says. That's because the studies supporting treatment with surgery had dramatic results, leading to wide endorsement of that approach. Many people are already good candidates for the stents, Katzen said. For anyone who has had the surgery, who has had radiation treatment for a neck tumor or has poor cardiac function, the carotid surgery would be high risk.