Endovascular Treatment of Carotid Artery Pathologies

Endovascular treatment of carotid artery pathologies encompasses minimally invasive techniques designed to restore or preserve cerebral perfusion by addressing stenosis, occlusion or anatomical anomalies of the carotid arteries. The approach typically involves percutaneous vascular access, image‐guided navigation of microcatheters and deployment of specialised devices such as stents or thrombectomy tools. Beyond conventional balloon angioplasty and stenting for atherosclerotic stenosis, contemporary practice includes tailored strategies for tortuosity, kinking and complex occlusive disease. Real-time imaging and enhanced catheter designs have improved procedural success, reduced complication rates and broadened indications to patients with challenging arch anatomy or comorbid connective tissue disorders. Attention to extracranial vessel morphology and patient-specific factors now informs choice of access route, device selection and peri-procedural management. Collectively, these advances have translated into faster revascularisation times, lower stroke recurrence and more consistent functional outcomes, underscoring the global significance of endovascular options as first-line or adjunctive therapies in carotid artery disease.

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Endovascular Treatment of Carotid Artery Pathologies publication trend

The graph below shows the total number of articles in endovascular treatment of carotid artery pathologies across all publications each year (not limited to Nature Index journals).

Technical terms

Endovascular treatment: Minimally invasive procedures performed within blood vessels to restore flow, using catheters and devices introduced through the skin.

Mechanical thrombectomy: The percutaneous removal of intravascular clots using stent-like retrievers or aspiration systems to reestablish blood flow.

Revascularisation: Restoration of adequate blood supply to brain tissue, often measured by angiographic grading scales.

Carotid artery tortuosity: Excessive twists or curves in the carotid artery that can complicate device navigation and alter haemodynamics.

Direct carotid puncture: Percutaneous access to the carotid artery in the neck, employed when conventional femoral or radial routes are not feasible.

References

1. Age-Related Tortuosity of Carotid and Vertebral Arteries: Quantitative Evaluation With MR Angiography. Frontiers in Neurology (2022).
2. The prognostic value of extracranial vascular characteristics on procedural duration and revascularization success in endovascularly treated acute ischemic stroke patients. European Stroke Journal (2022).
3. Trans-Carotid and Trans-Radial Access for Mechanical Thrombectomy for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Cureus (2020).
4. Direct puncture of the carotid artery as a bailout vascular access technique for mechanical thrombectomy in acute ischemic stroke—the revival of an old technique in a modern setting. Neuroradiology (2020).
5. Carotid Artery Tortuosity Is Associated with Connective Tissue Diseases. American Journal of Neuroradiology (2019).