This historical feature traces the evolution of carotid artery stenting from early balloon angioplasty to modern stent and embolic protection systems, highlighting how multidisciplinary collaboration and clinical trials established it as a safe, effective, and reimbursed alternative to carotid endarterectomy for stroke prevention.
Globally, stroke is the second leading cause of death, accounting for ∼7 million deaths annually, and the third leading cause of death and disability combined, responsible for more than 160 million disability-adjusted life-years lost.1 According to the American Heart Association, stroke is the fifth leading cause of death in the United States. In 2021, age-adjusted stroke mortality rose by 8.4%, with a 26.3% increase in absolute deaths.2 Although severe carotid artery stenosis accounts for approximately 20% of ischemic strokes, the overall burden of strokes attributed to carotid atherosclerosis is likely higher due to cases—previously considered cryptogenic—now linked to atheroembolism from ruptured nonstenotic plaques.
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Chaturvedi et al. (2026) studied this question.
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