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Heart doi:10.1136/heartjnl-2011-301218
  • Technology and guidelines

NICE carotid artery stenting: a summary of the 2011 guidelines

  1. Alison W Halliday1,2
  1. 1Department of Vascular Surgery, John Radcliffe Hospital, Oxford, UK
  2. 2Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Professor Alison W Halliday, Nuffield Department of Surgical Sciences, Level 6, John Radcliffe Hospital, Headley Way, Oxford OX3 9DU, UK; alison.halliday{at}nds.ox.ac.uk

  1. Contributors SKN performed the literature search. AWH and SKN were jointly responsible for writing the article.

  • Accepted 18 October 2011
  • Published Online First 29 November 2011

Abstract

Atherosclerotic disease of the carotid bifurcation is associated with an increased risk of both stroke and transient ischaemic attack. Carotid artery stenting (CAS) offers an alternative approach to carotid endarterectomy (CEA) in both symptomatic and asymptomatic individuals. The National Institute for Health and Clinical excellence (NICE) guidance for CAS in symptomatic subjects supports CAS with some caveats. The procedure should be carried out by an experienced clinical team with a good track record and there should be careful attention to audit and long-term follow-up. The case for CAS in asymptomatic carotid artery stenosis is not yet proved. For asymptomatic disease, NICE recommends that where CEA and CAS are clinically appropriate and technically feasible, patients should be randomised within the second Asymptomatic Carotid Surgery Trial (ACST-2).

Footnotes

  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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