Carotid Artery Stenosis (Symptomatic and Asymptomatic)

This randomized controlled trial aims to evaluate whether a proximal-distal dual cerebral protection strategy can reduce the occurrence of new cerebral ischemic lesions compared with a single cerebral protection strategy in patients undergoing carotid artery stenting. Eligible participants will be randomly assigned to receive either dual cerebral protection using proximal flow control combined with a distal embolic protection device or conventional single cerebral protection. Brain magnetic resonance imaging will be performed after the procedure to assess new ischemic lesions. The study will also evaluate peri-procedural neurological events and other safety and efficacy outcomes.

This prospective observational study aims to compare the diagnostic performance of non-contrast magnetic resonance angiography (NC-MRA) and carotid Doppler ultrasonography in the evaluation of carotid artery disease among patients with ischemic cerebrovascular stroke or transient ischemic attack. A total of 200 adult patients presenting to Sohag University Hospital will undergo both imaging modalities. The study will assess the agreement between NC-MRA and carotid Doppler in detecting and grading carotid artery stenosis according to the NASCET criteria, with the goal of evaluating the clinical utility of each technique and optimizing imaging strategies for the assessment of cerebrovascular stroke.

Carotid angioplasty and stenting (CAS) is an effective treatment for carotid artery stenosis but carries a risk of cerebral embolization. This prospective randomized study evaluates the safety and efficacy of proximal embolic protection using a balloon guide catheter during CAS by comparing the incidence of diffusion-weighted MRI-detected microembolisms and symptomatic thromboembolic events between protected and unprotected procedures.