Clinical outcomes of carotid artery stenting in an experienced center

Carotid artery stenting (CAS) is increasingly used as an alternative revascularization strategy for carotid artery stenosis, particularly in selected patients treated at experienced centers. The aim of this study was to evaluate procedural safety, technical performance, and clinical outcomes of CAS performed using a uniform endovascular strategy at a single institution. In this retrospective analysis, 120 consecutive patients with angiographically documented carotid artery stenosis ranging from 50% to 99% underwent carotid artery stenting. Both symptomatic and asymptomatic cases were included. All interventions were performed by senior operators using a standardized stent system, with cerebral protection devices used whenever anatomical conditions permitted. Clinical and imaging-based outcomes were reviewed over a follow-up period of 5 to 84 months. Successful stent deployment was achieved in all cases, yielding a technical success rate of 100%, with no procedure-related deaths. Periprocedural myocardial infarction occurred in two patients (1.6%). One patient (0.8%) experienced an ischemic event within the treated vascular territory, while another patient (0.8%) developed thromboembolic occlusion of the ipsilateral middle cerebral artery requiring thrombectomy, without persistent neurological impairment. Transient neurological symptoms were observed in two patients (1.6%) after bilateral stenting procedures. During follow-up, in-stent restenosis was identified in three patients (2.5%), with reintervention required in only one case. No stent occlusions were detected. When performed by experienced teams using a consistent endovascular technique and routine cerebral protection, carotid artery stenting is associated with high procedural success and low rates of adverse events. These results support the role of CAS as a safe and effective revascularization option in appropriately selected patients.