Characterization of carotid Plaque for the indication of carotid angioplasty and stenting - The ICAROS Registry

The potential for cerebral embolization and consequent neurological complications, still represent a major concern for carotid angioplasty and stenting. With the purpose of a better selection of the characteristics of carotid lesions more prone to balloon angioplasty and giving a lower risk of embolization, we set-up the ICAROS Registry. ICAROS is a multicentre registry, which correlates the immediate outcome and the follow-up of carotid angioplasties with the echographic characterization of the carotid plaque. The computer elaboration of the echographic image has shown its validity in clinical and natural history studies, in better defining the risk of neurological events and the indication to surgery. The same method, when applied to carotid angioplasty, can identify those plaques which can undergo angioplasty and stenting with minimal embolizing potential. Recently refined techniques of cerebral protection during PTA, through filters or occlusion balloons, while representing a safer procedure, allow direct correlation between filtered particles and morphologic plaque characterization.