Angioplasty and stenting for stroke prevention: good questions that need answers.

Extracranial and intracranial angioplasty and stenting of the cerebral vessels are being performed more frequently. One clinical trial demonstrated equivalent outcomes between extracranial carotid angioplasty and carotid endarterectomy, but the results in both groups were suboptimal. Concerns remain about the iatrogenic stroke rate after angioplasty, especially for asymptomatic patients. Angioplasty, with or without stent placement, also offers a potential new therapeutic approach for patients with intracranial stenosis and vertebrobasilar lesions, although these procedures have been performed in uncontrolled fashion.