Carotid revascularisation: the right patient, the right approach

The management of carotid stenosis continues to evolve, with treatment decisions increasingly shaped by patient characteristics, anatomical considerations, and the available revascularisation techniques.

In this PVI 2026 interview, Dr Caitlin Hicks and Dr Gustavo Basso explore the lessons of CREST-II and the role of optimal medical therapy, before discussing how to tailor the choice between transfemoral carotid artery stenting (CAS), carotid endarterectomy (CEA), and T-CAR to each patient.

They examine the importance of anatomical considerations and operator expertise, alongside the specific indications and benefits of T-CAR, the impact of contralateral carotid occlusion, plaque assessment using hand-held ultrasound devices (HUDs), and emerging stent technologies, including micro-mesh stents.

The discussion also addresses the management of asymptomatic carotid disease, the role of surveillance, and treatment considerations in the setting of acute stroke.

Discover how patient selection, anatomical considerations, and procedural expertise can help guide carotid revascularisation strategies.