Episode # 631 • 07 Apr 2026
Advancements in Carotid Stenting
Clean lumen club! This week, BackTable meets you at the carotid bifurcation to discuss all things carotid angioplasty and stenting. Interventional neuroradiologist and cerebrovascular surgeon Dr. Adnan Siddiqui, Vice Chairman of the University of Buffalo’s Department of Neurosurgery, joins host Dr. Sameh Sayfo to discuss the evolution and current state of carotid disease treatment.
This podcast is supported by
Timestamps
00:00 - Introduction
02:48 - From Aspirin to Endarterectomy
03:47 - Rise of Carotid Stenting
06:46 - CREST-2 and CMS Coverage
09:57 - Management of Severe Asymptomatic Carotid Stenosis
15:35 - New Stent Designs Explained
17:56 - Five Tips for New Operators
20:08 - Case Selection Algorithm
22:04 - Learning Curve and Mentorship
28:27 - What’s Next: IVL and Outpatient
31:24 - Managing Complications Safely
35:05 - Closing and Credits
Resources
- Dr. Adnan Siddiqui provider profile
- Carotid Endarterectomy for Asymptomatic Carotid Stenosis: Asymptomatic Carotid Surgery Trial (ACAS)
- Asymptomatic Carotid Surgery Trial (ACST-2)
- Protected Carotid-Artery Stenting versus Endarterectomy in High-Risk Patients (SAPPHIRE trial)
- Medical Management and Revascularization for Asymptomatic Carotid Stenosis (CREST-2 trial)
- The North American Symptomatic Carotid Endarterectomy Trial (NASCET trial)
You may also like
More about this episode
Dr. Siddiqui details the history of carotid stenosis treatment, charting its path and progression from medical therapy to endarterectomy and modern stenting approaches. He includes how recent trial data and updated CMS reimbursements have influenced practice and generated recent developments such as second generation stent technology. Dr. Siddiqui shares perspectives on patient selection, operator learning curve, complication preparedness, and the importance of structured training and proctoring as technology and techniques continue to improve. The physicians close by overviewing future directions for the carotid space such as IVL and how to approach management of procedural complications.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.