Carotid Artery Stenting Without Protection
Carotid Artery Stenting Without Protection
A recent randomized Carotid artery stenting (CAS) trial in which carotid protection device
 (CPD)s were used to demonstrate equivalence with carotid endarterectomy (CEA) by achieving
 noninferiority regarding periprocedural risk. However, the clinical efficacy and safety of
 CPDs are still a matter of controversy. It has been argued that the limited reduction
 provided by CPDs may be due to the devices themselves. Probably, they serve as sources for
 emboli during the procedure or removal technique. In general, 30- day adverse outcome for CAS
 with the use of CPDs seems not to be different from the outcome without CPDs.

 Thus, the main goal in this study is to test the hypothesis that CAS without CPD usage is as
 safe as in those patients who undergo CAS with CPD neuroprotection.
The Carotid Artery Stenting without Embolic Protection (CASWEP) trial is designed in a
 prospective, randomized, multi-center fashion to determine if CAS without CPD is feasible and
 safe in patients with symptomatic or asymptomatic severe carotid stenosis.

 Study participants After the exclusion criterias were applied 279 patients were divided as
 139 patients in the CAS with CPD arm and 140 patients in the CAS without CPD arm. Our study
 population includes patients with severe carotid artery stenosis referred to the 3 study
 center hospitals.
Inclusion Criteria:

 -  Symptomatic patients with ≥ 50% ipsilateral carotid stenosis by angiography, ≥70% by
 duplex ultrasound, or ≥70% by Computerized tomography (CT) angiography or Magnetic
 Resonance (MR) angiography if the stenosis on ultrasonography was 50% to 69%.

 -  Asymptomatic patients with ≥60% stenosis by angiography, ≥70% by ultrasound, or ≥80%
 by CT angiography or MR angiography if the stenosis on ultrasonography was 50% to 69%.

 Exclusion Criteria:

 -  Total occlusion,

 -  Visible thrombus at the lesion site

 -  Bleeding diathesis

 -  Cerebral vascular malformation,

 -  Degenerative cerebral diseases

 -  Cerebral tumors

 -  Illness impeding informed consent

 -  Life expectancy<2 years

 -  Previous CEA.